Independent PBM Oversight, Built on the Claims Themselves

A PBM report is prepared by the PBM and typically shows selected performance measures. Independent reimbursement oversight, such as the analysis Stratos Insights provides, examines the underlying claims data to test whether reimbursement behavior and financial outcomes actually match expectations. The difference is independence and claims-level detail.

No. Stratos complements existing reporting by adding an independent, claims-level layer of validation and visibility. Organizations use Stratos to confirm what their PBM or payer reports are telling them and to surface patterns, like below-cost claims or spread pricing exposure, that summary reports often miss.

Stratos analyzes claims activity, reimbursement behavior, payer performance and cost data to help organizations understand financial performance at a more granular level. This claims-level approach reveals patterns, such as below-cost claims, spread pricing exposure and reimbursement trends, that summary reports typically do not surface.

No. Stratos is not a pharmacy benefit manager. Stratos provides independent reimbursement oversight and claims-level analysis. It helps organizations better understand PBM reporting, reimbursement behavior and financial outcomes, but it does not administer pharmacy benefits, process claims as a PBM or manage formularies.

No. Stratos does not negotiate contracts on a client’s behalf. Stratos focuses on independent reimbursement visibility, claims-level analysis, PBM oversight and profitability intelligence.

Stratos handles claims and reimbursement data inside a SOC 2 Type 2 environment, with security controls built for sensitive healthcare and financial information. Data is used solely for independent analysis on behalf of the client organization, so the resulting insight is both defensible and responsibly managed.