For Health Plans
Require modern. Require auditable.
Require NexusLedge.
Drive top-down adoption by mandating that your PBMs operate on a platform where every AI decision is logged, explainable, and configurable.
Oversight Without Micromanagement
Visibility into PBM operations
Audit Trail
Every PA action, every AI inference, every clinical decision is logged with timestamp, user, and full context. HIPAA-compliant.
SLA Visibility
Real-time SLA monitoring across your PBM network. Configurable thresholds at the health plan level.
CMS 2026 Compliance
NCPDP SCRIPT v2023011 built in. Your PBMs are ePa-ready when you require NexusLedge.
Hierarchy-Aware Policy
Health plans set policy at their level. PBMs execute within those bounds. Configuration flows down the 7-level hierarchy.
Regulatory Confidence
Every AI decision is explainable
No black boxes. AI prompts are stored as configurable controls. Inference inputs and outputs are logged. Your compliance team can audit every assessment.
See how health plans drive PBM modernization
Learn how NexusLedge's hierarchy-aware platform gives health plans policy control.
See the Platform