Audience
Prescription Benefit Managers (PBMs), Third-Party Administrators (TPAs), Self-Funded Employers, Health Plans, Hospitals & Health Systems, Pharmaceutical Manufacturers, Cash & Discount Card Sponsors, Retail Chain Pharmacies
About Adjudicator
Adjudicator is a plan management and prescription claims adjudication platform for pharmacy benefit managers, health plans, hospitals and health systems, pharmacy programs, managed care organizations, manufacturers, and retail pharmacies. It supports configurable plan designs and benefit structures, multi-tenant environments, pharmacy network configurations, and management of drugs, formularies, and maximum allowable cost (MAC) pricing. Its member portal provides real-time benefit-status and pending-claim tracking, secure document uploads, and notifications. A prior authorization dashboard provides access to claims data and secure communications. An API framework supports data exchange with internal processes and external business partners. Adjudicator helps organizations manage pharmacy benefits and prescription claims.