Service
Actionable Analytics
Independent claims data analysis and reconciliation
Most pharmacy data reports tell you what already happened. TeliosRx Actionable Analytics tells you what to do about it. We pull claim-level pharmacy data directly from your PBM, normalize it against contract terms, and produce reports that surface specific savings opportunities, by drug, by member, by pharmacy, by channel. Then we translate those findings into PBM-level actions: formulary changes, PA criteria adjustments, network configuration, member outreach.
What's Included
- Claim-level data ingestion and normalization
- Top-spend drug and member analysis
- Pharmacy network optimization review
- Specialty drug channel analysis (pharmacy vs medical benefit)
- Generic substitution and biosimilar opportunity quantification
- Monthly or quarterly cadence reporting
Our Process
- Establish data feed from PBM and claims warehouse
- Build baseline analytics dashboard
- Identify top 5-10 actionable findings
- Translate findings into specific operational changes
- Execute changes with PBM and member communications
- Track impact in subsequent reporting cycle
Who This Is For
Plans 1,000+ lives that want to actively manage pharmacy spend rather than just receive PBM-prepared summaries.
Financial Analysis
Optimize Your PBM Savings Today!
Ready to lower pharmacy costs without compromising the quality of your benefits?
A thorough pharmacy analysis goes beyond price comparisons, uncovering hidden costs and ensuring informed decisions to maximize savings and minimize disruptions.
Gain insights, strategies, and cost control for your pharmacy benefits program.
- Data-Driven Decisions
- Aligned Incentives
- Cost Containment