See what your PBM isn't showing you.
Kanurra is a pharmacy benefit manager that earns one flat fee whether your drugs are cheap or expensive. Bring your claims and we will open them line by line.
Built for self-funded and level-funded plans.
On your 30-minute audit
Bring a recent claims file if you have one. If you don't, we will open the same detail on a representative claim and tell you exactly what to ask your current PBM for.
- See claims, rebates, and specialty spend line by line
- See what your current contract keeps, fill by fill
- Leave with the numbers, whatever they say. No cost, nothing to sign
What a PBM audit can uncover
Your pharmacy benefit may look straightforward on a summary report, but the underlying claims can tell a different story. A PBM audit report gives employers a closer look at how pharmacy claims are priced, how rebates are handled, and where additional fees or costs may appear. PBM rebate audits can also help verify how rebate amounts are calculated and credited back to the plan.
A claim-level review can help you understand:
- Drug pricing: What the pharmacy was paid compared with what your plan was charged.
- PBM fees: Administrative, dispensing, or other fees included in your pharmacy benefit arrangement.
- Rebates: What rebates are generated and how they are credited back to the plan.
- Specialty spend: Which specialty prescriptions are driving pharmacy costs and how they are priced.
- Contract terms: Whether the pricing, guarantees, and other terms in your PBM contract can be verified against actual claims.
The goal isn't to assume your PBM is doing something wrong. It's to give you the numbers and the detail you need to understand your pharmacy benefit.
Frequently asked questions
What is a PBM audit?
It is a review of your pharmacy benefit claims, pricing, rebates, fees, and applicable contract terms. It helps employers understand how their pharmacy benefit is being priced and administered.
Why should I audit my PBM?
A PBM audit can help you see how much your plan is paying for prescriptions, how rebates and fees are handled, and whether the numbers in your reporting align with the terms of your current PBM contract. A PBM rebate audit can also help you review how rebate amounts are calculated and credited back to the plan.
What do I need for a PBM audit?
A recent claims file is the best place to start. If you don't have one, Kanurra can review a representative claim and explain what information you should request from your current PBM.
Can an audit identify hidden fees or spread pricing?
A claim-level review can help identify differences between what your plan is charged and what the pharmacy is paid, as well as fees or other amounts included in the arrangement. The exact analysis depends on the claims data and contract information available.
Can I audit my current PBM without switching?
Yes. You can review your existing pharmacy benefit before deciding whether to make any changes. A pharmacy claims audit uses your claims and contract information to help you understand your current arrangement.
Do I have to switch to Kanurra after the audit?
No. The audit is focused on understanding your current pharmacy benefit. There is no requirement to switch PBMs, and there is no cost or contract required for the 30-minute audit.