Click a question below to reveal the answer.  See our MaximizeRx and clinical support Q&As below. Also, check out our new AI artificial intelligence Q&As.

General Questions

ALTTRAX is a pharmacy benefit strategy firm. We’re not a PBM—we work alongside your existing vendor(s) to help you take control of pharmacy performance, spend, and governance. Our goal: help plans design smarter, more accountable pharmacy benefit models without defaulting to a one-size-fits-all carve-out.

PBMs manage drug pricing and claims. We manage the strategy that governs them. PBMs often operate with hidden incentives. ALTTRAX works solely on your behalf—bringing transparency, clinical alignment, and implementation support to the decisions your PBM won’t make for you.

Not necessarily. Many clients work with us to optimize within their existing PBM relationship, identify hidden cost drivers, and improve outcomes through plan design, governance, and oversight. We also help clients evaluate or transition PBMs when the time is right.

We support:

  • Self-funded employer groups
  • Regional and national health plans
  • Labor unions and Taft-Hartley funds
  • Public-sector entities
  • Pharmacy coalitions and benefit consultants

If you’re responsible for managing pharmacy strategy—we’re built for you.

We help you:

  • Design and negotiate aligned PBM contract and service models
  • Analyze clinical and financial performance across drug classes
  • Build governance frameworks to hold vendors accountable
  • Support execution during implementation and renewals
  • Bring strategic clarity to every pharmacy decision you face

We are vendor-neutral and conflict-free. Our compensation is fully transparent, typically structured as a flat engagement fee or project-based pricing. We do not accept rebates, commissions, or incentives from PBMs or drug manufacturers.

Many clients see immediate value from early diagnostics—such as uncovering misaligned formularies, unnecessary specialty inflation, or member disruption risks. Larger initiatives (e.g., contract overhauls, carve-in/outs, formulary redesigns) typically deliver measurable impact within 3–9 months.

No—we often partner with brokers, actuaries, and consultants. ALTTRAX provides deep clinical, operational, and implementation-level support that complements those roles. We’re the execution layer between strategy and PBM delivery.

Yes. We have experience supporting complex, high-need populations including:

  • Dual eligibles
  • Managed Medicaid
  • State plans and MCOs

Our team understands the regulatory, financial, and clinical nuances of these populations.

Most clients begin with:

  • Strategic Diagnostic – uncover clinical, financial, and operational gaps
  • Targeted Plan Redesign or Vendor Evaluation
  • Implementation or Oversight Support

Each engagement is customized based on your goals, population, and vendor relationships.

MaximizeRx

MaximizeRx is your end-to-end solution, covering everything from proposals to benefit management, implementations, and beyond. What sets us apart? Agility and transparency. We don’t do one-size-fits-all—we tailor our recommendations to fit your needs, nothing more, nothing less. And with us, you’ll always know exactly what you’re paying for—no hidden fees, no surprises. Just smarter savings.

Managing pharmacy benefits can feel like trying to play Chopsticks on a giant floor piano—challenging, awkward, and way harder than it looks. Here’s how MaximizeRx makes things simpler:

  • PBM Contract Assessment – No Surprises, Just Insights – We analyze your contract to uncover hidden savings and negotiation opportunities, so you don’t get stuck in a deal you don’t understand.
  • Pharmacy Audits – Avoid Costly Mistakes – From pharmacy benefits to Medicaid, Medicare, and 340B audits, we help you find inefficiencies before they turn into major problems.
  • Performance Monitoring – Your Data, But Make It Useful – Our tech platform translates pharmacy data into clear, actionable insights. No cryptic spreadsheets required.
  • Pharmacy Oversight – A Grown-Up Strategy – From financial support to market checks, we help you make the right moves to maximize efficiency.
  • Clinical Strategies – Smart Spending for Big Savings – Optimize outcomes and reduce costs with innovative clinical solutions that enhance medication management, improve adherence, and drive value-based care.
  • Innovative Pharmacy Solutions – Because There’s Always a Smarter Way – Our cost-saving programs ensure that quality care doesn’t come with an outrageous price tag.

Visit our MaximizeRx page to see how we can help you take control of your pharmacy benefits—without wishing for a do-over.

Clinical

Pharmacy spend is one of the fastest-growing components of healthcare costs. Without independent clinical oversight, programs may look good on paper but fail to deliver valuable outcomes. ALTTRAX helps uncover where PBM strategies fall short and where improvements can drive better results.

We apply an evidence-based approach to assess things like formulary design, utilization management, specialty oversight, and adherence initiatives. Our evaluations go beyond surface-level reporting to reveal what’s working, what’s not, and where gaps exist.

Unlike PBMs, we are independent. Our only priority is ensuring that employers, brokers and consultants get unbiased insights and actionable recommendations. We identify conflicts of interest and help align pharmacy strategy with improved health outcomes.

We serve as the pharmacy experts behind the scenes — equipping consultants and brokers with data-driven analysis, market insights, and clear recommendations that strengthen their client relationships and position them as trusted advisors.

Yes. Every employer population is unique. We tailor our evaluations and strategies based on workforce demographics, utilization patterns, and cost drivers to ensure programs are aligned with specific client goals.

AI Artificial Intelligence

ALTTRAX is introducing a powerful new capability that helps organizations gain traction: artificial intelligence. We combine deep pharmacy expertise with proven AI solutions to make teams faster, smarter, and more effective without replacing people.

AI supports teams by providing real-time insights, simplifying complex information, and accelerating decision making. Imagine a customer service representative instantly understanding how a claim was processed and explaining it in plain language. That’s the kind of efficiency AI makes possible.

Other organizations offer AI, but they can’t match our combination of:

  • Deep pharmacy benefit expertise
  • Practical operational experience
  • A consultative, not sales-driven approach

We’re not here to sell multi-year engagements. We focus on quick, effective solutions that deliver measurable ROI.

Contact ALTTRAX to schedule a Rapid Assessment. We’ll help you determine whether AI is the right fit and outline a clear, actionable path forward.

No. Our approach empowers people, not replaces them. AI handles repetitive processing so teams can focus on higher-value work that requires judgment, empathy, and expertise.

Organizations often face:

  • Complex pharmacy benefits
  • Increasing member expectations
  • Service teams stretched thin

ALTTRAX can deliver AI solutions to streamline operations and help you deliver exceptional customer and member experiences.

We provide clarity: insight through assessment, direction through a clear roadmap, and simplicity through vetted, easy-to-implement solutions, all designed to deliver proven ROI.

Examples of tools we help organizations deploy include:

  • Real-Time Agent Assist: Instant answers for customer service agents
  • Accent Neutralization: Improves clarity and communication
  • Real-Time Translation: Supports conversations with non-English-speaking members
  • AI Agents: Reduce administrative workload associated with member inquiries, prior authorizations, and appeals

These tools integrate securely and can be tailored to your operation.

AI solutions are compliant with industry data-security standards and provide real-time insights without exposing sensitive information. Your data stays within your control, providing peace of mind.

We start by reviewing your AI roadmap or helping you build your first one. Through Rapid Assessments, interviews, and observation, we identify improvement opportunities. AI is recommended only when it meaningfully supports your goals.

Implementations can take as little as two weeks, depending on readiness and scope. ALTTRAX focuses on speed-to-value so you see results quickly.

ALTTRAX AI solutions are ideal for:

  • Health plans
  • TPAs
  • Brokers
  • Healthcare service organizations

Anyone looking to improve contact center performance or navigate complex pharmacy benefits will benefit from our approach.