Mid-market PBMs
- Scale operations without heavy capital investment
- Reduce manual effort across claims and pricing workflows
- Improve transparency and member engagement
Pharmacy Benefit Management
AI-powered PBM workflows that improve transparency, reduce revenue leakage, and enhance member experience across claims, formulary, pricing, and engagement.
Value Delivered
AI-enabled PBM platforms designed to modernize claims, pricing, and compliance workflows while improving operational control and member experience.
20
%Reduction in Revenue Leakage via Auto-Captured Billables and Optimized Workflows.
3
XHigher Member Portal Adoption through Intuitive, Engaging Digital Experiences.
40
%Faster Claim Cycle Times with Automated Adjudication and Streamlined Processes.
30
%+Efficiency Gains in Drug Pricing and Rebate Reconciliation.
85
%+Reduction in Manual Effort by Automating Compliance and Security Tasks.
<
30
minEnvironment Provisioning through Advanced DevOps and Cloud Automation.
100
%HIPAA-Compliant Foundation ensuring Data Security and Regulatory Adherence.
20
%Improvement in Cost Control with Advanced Drug Pricing Transparency.
Who We Serve
Veltris works with Pharmacy Benefit Managers and payer organizations navigating increasing pressure around cost transparency, compliance, and member experience—while operating on complex, legacy-heavy platforms.
What We Do
Powered by the Veltris Vertical AI Platform (V2AP), we help PBMs build scalable, compliant, and member-centric platforms that support core PBM operations and digital engagement.
- Digital member experience platforms (web and mobile)
- Integrated pharmacy network and claims data hubs
- Real-time eligibility and benefits dashboards
- Secure, HIPAA-compliant cloud foundations
Veltris helps PBMs modernize legacy systems and workflows using AI-driven automation and Veltris Intelligent Assistants (VIA) to reduce manual effort, improve accuracy, and accelerate claims and pricing operations.
- Automated claims adjudication and rebate workflows
- Payer–PBM data harmonization for real-time reporting
- Cloud migration and DevOps automation (AWS / Azure)
- API-first integrations with drug pricing and formulary systems
We help PBMs unlock value from data and member relationships by improving pricing transparency, revenue capture, and engagement outcomes.
- Formulary and drug pricing transparency tools
- Predictive models for payment and rebate optimization
- Digital member engagement and savings journeys
- Improved revenue capture and reduced leakage
These capabilities are accelerated through Veltris’ PBM-focused AI solutions, such as VeloRx, designed to improve pricing transparency, rebate optimization, and member engagement.
What We Do
Powered by the Veltris Vertical AI Platform (V2AP), we help PBMs build scalable, compliant, and member-centric platforms that support core PBM operations and digital engagement.
- Digital member experience platforms (web and mobile)
- Integrated pharmacy network and claims data hubs
- Real-time eligibility and benefits dashboards
- Secure, HIPAA-compliant cloud foundations
Veltris helps PBMs modernize legacy systems and workflows using AI-driven automation and Veltris Intelligent Assistants (VIA) to reduce manual effort, improve accuracy, and accelerate claims and pricing operations.
- Automated claims adjudication and rebate workflows
- Payer–PBM data harmonization for real-time reporting
- Cloud migration and DevOps automation (AWS / Azure)
- API-first integrations with drug pricing and formulary systems
We help PBMs unlock value from data and member relationships by improving pricing transparency, revenue capture, and engagement outcomes.
- Formulary and drug pricing transparency tools
- Predictive models for payment and rebate optimization
- Digital member engagement and savings journeys
- Improved revenue capture and reduced leakage
These capabilities are accelerated through Veltris’ PBM-focused AI solutions, such as VeloRx, designed to improve pricing transparency, rebate optimization, and member engagement.
VeltrisOne™ - Purpose-Built Vertical AI for Healthcare
Healthcare AI delivers value only when intelligence is embedded into the platform - not added as a layer later. VeltrisOne™ provides a secure, scalable foundation that powers productivity, industry-specific workflows, and enterprise-scale execution across healthcare ecosystems.
Client Case Studies
FAQs
AI helps PBMs identify and capture missed billable events, reconcile rebates more accurately, and flag inconsistencies in claims and pricing workflows. By automating these processes and applying predictive analytics, PBMs can significantly reduce revenue leakage while improving accuracy and audit readiness.
Yes. Veltris designs PBM platforms with security and compliance built in from the ground up. This includes HIPAA-aligned cloud architectures, encryption of data at rest and in transit, access controls, audit logging, and governance mechanisms that support regulatory requirements.
Modernizing PBM systems to cloud-native architectures enables faster claims adjudication, near real-time analytics, and seamless integration with pricing, formulary, and partner systems. This reduces manual effort, improves scalability, and allows PBMs to respond more quickly to market and regulatory changes.
Yes. Veltris helps PBMs design intuitive member portals and digital engagement journeys that make it easier for members to understand benefits, pricing, and coverage. Improved self-service and transparency lead to higher adoption, fewer support calls, and better member satisfaction.
Veltris combines deep PBM domain expertise with AI-driven automation and cloud-native platforms. Our approach focuses on measurable outcomes—such as faster claim cycles, improved pricing transparency, reduced manual effort, and stronger revenue control—rather than point solutions or one-off implementations.
Partnerships
Technology Towers
