Ep. 5 - Claim Adjudication and Reconciliation: Key Concepts Plan Sponsors Should Know
About this episode
This episode discusses the critical components of claim adjudication and reconciliation in pharmacy benefit management and their implications for plan sponsors.
Claim adjudication and claim reconciliation are critical — but often misunderstood — components of pharmacy benefit management. In this episode of Benefits Bites, Mike and Madison break down how these processes work, why they matter for plan sponsors and how recent legislative and regulatory changes are reshaping rebate and price guarantee requirements. Register for upcoming Employers Health webinars or watch on demand at https://www.employershealthco.com/resource-center/events/ Sign up for our monthly newsletter at https://www.employershealthco.com/#subscribe_cta Find additional helpful benefits strategies and resources at https://www.employershealthco.com/resource-center/articles/
People in this episode
Hosts: Mike, Madison
Topics covered
- claim adjudication
- claim reconciliation
- pharmacy benefit management
- plan sponsors
- legislative changes
- regulatory changes
Keywords
- claim adjudication
- claim reconciliation
- pharmacy benefits
- plan sponsors
- rebate requirements
- price guarantee
Mentioned in this episode
Organizations: Employers Health
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