Case Study: a large auto manufacturer recovers $1.4 million with Conduent pharmacy claim audit

a large auto manufacturer recovers $1.4 million with Conduent pharmacy claim audit

A large auto manufacturer had not audited its pharmacy benefit manager (PBM) in two years and needed to review its prescription drug claims before issuing a new RFP. They retained Conduent to conduct a pharmacy claim audit to review the PBM's compliance with its contractual plan obligations.

Using its proprietary ClaimInsight software for data analysis, Conduent reviewed the entire claims file, filtering data to avoid false positives. The audit process identified major errors in the PBM's prior authorization methodology. As a result, Conduent secured a $1.4 million refund for the client from the PBM.