For Independent and community pharmacies, single store or a small group
Track DIR and other fees taken back after the claim paid
The margin at the counter is not the margin you keep. DIR and other fees come out of later payments, sometimes months after the fill, and the size changes without warning. Owners plan on one number and get paid another.
What it can cost you
Example: $1.50 more in fees per script than planned x 4,000 scripts a month = $6,000 a month.An illustration, not a promise. Your Opportunity Scan puts a real number on it.
What the system checks overnight
- Reads fee deductions from PBM remittance files as they arrive.
- Matches fees back to the claims they relate to where the files allow.
- Compares fees taken to the amount you set aside or expected.
- Calculates margin per script after fees by PBM and plan.
- Flags months where fees jump compared to the prior months.
Where it reads from
- PBM remittance files
- PioneerRx
- BestRx
- Liberty Software
- QS/1
- QuickBooks Online
What happens when it fires
The owner reviews the change and adjusts cash planning. The system shows which PBM and plans moved and by how much.
Autonomy level: Suggest only. The brief tells you what changed and what to do. Nothing happens without you.
What we guarantee
Every remittance file is read and reconciled to expected fees within one business day of arrival. We agree on the metric before the Sprint starts and measure it over the first 20 business days after go-live. If we miss it, you get half your Sprint fee back. Dollar savings are tracked in your monthly saves log, reported rather than promised.
Questions
Our fee reports are hard to read. Can it really match them?
It reads the remittance files your PBMs or services organization provide. Where fees cannot be tied to single claims, it reports them by plan and month.
Does it give tax or accounting advice on fees?
No. It shows the numbers. How you book them is a question for your accountant.
Do I need new software for this?
No. The system reads from the tools you already use, with read-only access by default. A guardrail layer controls exactly which data the AI can see.
What does it cost?
A 3-week Sprint is $6,000 fixed and includes the morning brief plus one automation tied to an agreed metric. Ongoing support is $1,500 a month, or $500 a month to keep it running without new automations. If the agreed metric is missed over the first 20 business days after go-live, half the Sprint fee is refunded.
How is this different from a dashboard app or a free AI kit?
A dashboard app shows numbers when you go look. A free AI kit gives you the parts, and you do the setup, the upkeep, and the checking. Here the alarms are built for your kind of business, they watch outside data like market rates and rule changes alongside yours, and on Run or Keep-Running, the person who built them keeps them working and logs what they caught.
More alarms for independent pharmacies
Seven more things worth watching.
- Claims paid below costFlag pharmacy claims where reimbursement came in below your acquisition cost, by PBM, plan, and NDC, so you can see the pattern and appeal what you can.
- Will-call bags not reversedCount pharmacy will-call prescriptions not picked up, claims not reversed before the payer's window, and stock that should go back on the shelf.
- Dead and expiring stockFlag pharmacy stock with no dispensing in months, items nearing expiry, and products still inside wholesaler return windows, by value.
- Stockouts and owed fillsTrack pharmacy out-of-stocks, partial fills, owed quantities, and transfers out caused by missing stock, by NDC and week.
- Wholesaler cost increasesFlag pharmacy items where wholesaler cost jumped, generics bought off your primary contract, and OTC items priced below your target margin.
- PBM payments late or shortCompare expected PBM payments to deposits by payer and cycle, and flag late or short payments before they squeeze your cash for the next order.
- Staffing vs script volumeCompare pharmacy technician and pharmacist hours to scripts filled by hour and day, and flag short shifts and overtime building up before payroll.
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