Every claim, independently checked.
spent on prescription drugs in the U.S. each year
of that is wasted on avoidable, low-value scripts
prescriptions written every single year
prior authorizations per physician, per week
What slips through costs lives. And plan dollars.
PBM contract leakage. Spread pricing, missed rebates, hidden fees, and unilateral MAC resets.
Plan design leakage. Eligibility, accumulator, channel, copay, and biosimilar defects.
Clinical risk. Wrong drug, unsafe dose, dangerous combinations, and avoidable waste.
Fraud and conflicts. Doctor shopping, affiliated steering, collusion, and invented diagnoses.
The prescription is only half the audit.
Axeris also reads the PBM contract, independent price benchmarks, rebate guarantees, ownership relationships, eligibility spans, and plan design—then ties every variance back to the claim.
One quiet layer between every contract, claim, and payment.
Every claim walks these five steps before a dollar moves.
Terms arrive
The PBM contract, benefit design, eligibility, and claim arrive together.
Economics rebuilt
Allowed price, acquisition benchmark, MAC history, and rebate terms reconcile.
Member context
Clinical safety, eligibility, accumulator, and plan rules stay attached to the case.
Integrity checks
Spread, steering, channel leakage, fraud, and design defects surface instantly.
Evidence-backed verdict
Pay, recover, swap, dispute, or hold—with the source trail attached.
One claim, audited three ways at once.
Contract & pricing
Tests spread, rebate guarantees, MAC changes, fees, and acquisition benchmarks at claim level.
Plan & fiduciary
Finds ownership steering, eligibility gaps, accumulator defects, channel leakage, and plan-design failures.
Clinical & patient
Keeps dosing, interactions, FDA guidance, labs, genetics, allergies, and adherence in the same case.
50+ contract, administrative, and clinical signals, including
Built for payers who want an independent read of every contract and claim.
Axeris turns contract terms into executable checks, attaches the evidence to each case, and takes a share only of savings we verify.
Self-funded employers
Start in Shadow65% of insured Americans get coverage through one.
Health insurers
Run AdvisoryThin margins, hard audits, every denial contested.
Health systems
Enforce PolicyPrescribing varies widely between their own clinicians.
Verified savings climb as coverage expands
We don't push cheap drugs. We stop unsafe ones.
Paid on rebates and spread. Paid only on verified savings.
Denies automatically. Flags to a human, with evidence.
Reviewed months after payment. Caught before the claim is paid.
Swapped by price. Swapped only for true equivalents.
“Every flag ships with the evidence attached. That is the difference between a denial tool and a decision you can defend.”
Adan Eftekhari, Chief Executive Officer
