For PBMs Pricing
Pricing for pharmacy benefit managers

One rate per call. Nothing else to add up.

No seat licenses, no platform fee, no per-minute meter running while a member finds their ID card. You pay for calls we handle.

Starting at
50¢ per call

Your rate depends on volume, the scope of call types you hand us, and how complex your systems and formularies are. We quote it in writing after one scoping call.

Inbound pharmacy and member calls
Outbound campaigns and adherence outreach
Integration with your claims switch or PBM platform
Script design and escalation rules
Every call QA-scored and reported
Branded caller ID and STIR/SHAKEN work
Signed BAA and security documentation
Named service lead, 24/7 coverage

Ask about our answer-only billing: routine calls we resolve are billable, misdials and abandoned calls are not.

Administering medical benefits instead? See administrator pricing. Running a provider practice? See practice pricing.

How your rate is set

Three things move the number

Nothing hidden. These are the only variables in the quote we hand you.

Variable 01

Volume

Monthly call volume across every line you give us. Higher committed volume moves the rate down; we do not price it in secret tiers.

Variable 02

Scope

How many call types we take. A single pharmacy claims line prices differently from a full member and pharmacy service line plus outbound campaigns.

Variable 03

Complexity

Your systems, formularies, and script requirements. A modern API and a handful of formularies is straightforward; dozens of custom plan designs and a legacy switch is not.

81%of in-scope provider calls handled without staff at Acuity Group. Pharmacy and member lines run on the same EHVAhealth service.
For context

What a routine call costs you today

HandlingTypical cost per callTime to answerHours covered
In-house help desk tech$6–$12Queue dependentBusiness hours
Offshore BPO$2–$5Queue dependentExtended
EHVAhealthFrom 50¢Under 1 second24/7, every day
Billing

Simple enough to explain to finance in one sentence

1

We scope, then quote in writing

One call to map your call types, volumes, and systems. You get a fixed per-call rate, starting at 50¢, before you sign anything.

2

Onboarding is included

Integration, script design, testing, and go-live are part of the service, not a separate implementation invoice.

3

Monthly invoice, one line item

Calls handled × your rate. Volume and containment reporting arrives with it so you can reconcile every call.

4

Scale up or down freely

Annual enrollment triples your volume and the rate holds. No overage penalties, no unused-seat waste in the quiet months.

Pricing questions

The things finance asks first

Is 50¢ really the price?

It is where pricing starts, and plenty of programs land there. Your quoted rate depends on volume, scope, and complexity, and we put it in writing before you commit. There is no bait: the rate we quote is the rate we invoice.

Is there a setup or implementation fee?

No. Discovery, integration, script configuration, testing, and go-live are included in the per-call rate.

What counts as a billable call?

A call we answer and handle. Misdials, immediate hang-ups, and calls that never reach handling are not billed. Outbound attempts that do not connect are not billed either.

Do long calls cost more?

No. Pricing is per call, not per minute, so a thorough answer never costs you more than a rushed one. That is deliberate: we do not want anything in the model that rewards cutting a caller short.

Is there a minimum commitment?

We work on annual service agreements with monthly volume flexibility. Pilots are available for teams that want to prove the line on a single call type first.

What about outbound campaigns?

Same per-call model, including the caller ID branding and STIR/SHAKEN attestation work. See outbound calling for what that covers.

We run medical benefits, not pharmacy. Does this apply?

No. This page prices answering the pharmacy benefit calls that come in to a PBM or a health plan's pharmacy line. For medical benefit administration, see administrator pricing.

Hear it before you price it

Enter your work email and we will send you real recorded calls, on your formularies.

Or talk to our team at (866) 680-7870