Solutions

One partner. Every part of the pharmacy benefit.

From claims to clinical programs to specialty medication support — run on the same transparent, full pass-through model, top to bottom.

Core PBM Services

The foundation, handled right

Claims Administration

Real-time, point-of-sale claims adjudication with eligibility and coverage checks at every fill.

Nationwide Network

Retail, mail order, and specialty pharmacies — 50,000+ locations nationwide, sufficient for real member access. Not sure if your local pharmacy participates? Ask us and we'll confirm.

ID Cards & Communications

Member ID cards and communication materials, customized with your branding at no added cost.

Direct Member Reimbursement

A simple claim form for out-of-network purchases, processed and reimbursed per your plan design.

Clinical Programs

Evidence-based, not economics-based

Prior Authorization

Client-directed or fully managed review, built on evidence-based clinical criteria — your choice.

Step Therapy & Limits

Quantity limits, dose limits, and step therapy protocols configured around your population's needs.

Drug Interaction Monitoring

Concurrent drug utilization review flags interactions, safety issues, and dose optimization opportunities.

Retrospective Review

Ongoing review of approved claims for clinical appropriateness and potential fraud or misuse.

Specialty Medication Support

High-cost therapies get high-touch support

Specialty medications carry outsized cost and complexity. TruthRx partners with Amber Specialty Pharmacy — a national specialty pharmacy focused on rare disease, transplant, oncology, immunology, neurology, and fertility therapies — for proactive outreach, copay assistance coordination, and members who stay on therapy without surprise bills.

Amber Specialty Pharmacy Copay Assistance Coordination Discreet Home Delivery Refill Reminders by Text

Prior authorization for specialty drugs, reviewed for clinical necessity

Fast-tracked review keeps members from waiting on treatment they already need. Reach Amber Specialty Pharmacy directly at 844-896-7987 or my.amberpharmacy.com.

Built for both sides of the plan

Support your members and your team need

For Members

24/7/365 bilingual call center
Member portal for claims, refills & formulary lookup
Real-time pharmacy-counter support
Satisfaction surveys that actually get reviewed

For Plan Sponsors

Monthly, quarterly & custom reporting at no extra cost
Custom pharmacy network configuration
Quarterly fraud, waste & abuse audits
Rebate management & script-level remittance detail
Optional Programs

Add what your plan needs, skip what it doesn't

Amazon Pharmacy Mail Order Copay Accumulator Support Custom Formulary Maintenance Chronic Illness Compliance Reporting

90-day retail and Amazon Pharmacy mail-order options, so members can choose what's convenient for them.

Want to see how this fits your plan?

Tell us what you're working with — we'll show you exactly where the savings come from.