Reconciliation tools tell you what you're owed. Recoup Rx audits every claim against your actual contract terms, builds the appeal, and files it before the window closes. You only pay a percentage of what comes back.
You keep filling scripts. We chase the shortfalls.
835 files and a dispensing export — set up through a secure, HIPAA-compliant transfer. About 15 minutes of your time, once.
Each payment is checked against your real contract terms, NADAC benchmarks, and MAC lists — not assumed rates.
Appeal packets built to each PBM's own process. You approve with one tap; we file, track, and escalate.
Four ways PBMs quietly shortchange pharmacies — on every remittance.
Brand claims paid under your contracted AWP discount and dispensing fee.
Generics reimbursed under acquisition benchmarks — filed as effective-rate appeals.
The same fee taken twice across remittance periods. It happens more than you'd think.
Payments that quietly drop your professional fee to zero.
Tell us about your pharmacy. We'll reach out within one business day — no claims data needed until a secure transfer is in place.
The audit is free. If you move forward, we keep a percentage of dollars actually recovered — no monthly fee, no recovery, no charge. Ever.
Yes. We sign a Business Associate Agreement with your pharmacy before any claims data moves, and all transfers and storage are encrypted. Nothing is shared with wholesalers, PSAOs, or PBMs.
Reconciliation matches payments to the promise-to-pay. We go a level deeper — checking whether the adjudicated amount itself was wrong against your contract — and then we actually execute the appeals, which is the part that never gets done in a busy pharmacy.
PrimeRx, PioneerRx, Liberty, BestRx, Rx30/Computer-Rx and others — anything that can export dispensing data works.
This is a live demo with sample pharmacy data — tap through the pipeline, findings, and appeal engine. On the Data tab, you can even drop one of your own 835 files for a quick scan.
The free audit covers 90 days of remittances against your actual contracts — set up through a secure, HIPAA-compliant transfer.