When Mina Gobrail hears about another pharmacy being audited, he knows exactly what it means. Hours of digging through claims and paperwork, and likely, a painful clawback.
It’s not because of deliberate billing errors. Instead, it often comes down to missing documentation or incorrect codes, like receiving the wrong “limited use” code from a prescriber. Even experienced pharmacists can miss these details in a busy workflow.
“Pharmacies lose thousands of dollars on billing audits due to mistakes that could have been avoided,” said Gobrail. “These mistakes cost pharmacists a lot and burden our healthcare system.”
After more than 21 years in the field, Gobrail had seen these preventable errors happen across the industry. In 2023 alone, Ontario’s provincial drug plan clawed back $13.5 million from 716 pharmacies due to avoidable billing mistakes. For a small or mid-sized pharmacy, the hit was estimated at around $36,000, enough to wipe out profits for the year.
The birth of AlertRx
Gobrail teamed up with co-founder and CTO Mina Michail to launch AlertRx, a software solution built by pharmacists, for pharmacists, to catch billing errors in real time.
As soon as a pharmacist fills a prescription, AlertRx runs a check in the cloud and sends an alert in milliseconds if something’s off, such as the wrong code, missing documentation, or an ineligible claim.
“I was very determined on getting instant alerts,” said Gobrail. “If we don’t catch the mistake at the right time, it’s already too late.”
The software currently checks against 130 rules to help pharmacists catch issues before the prescription leaves the counter. Pharmacies also receive a daily email report and access to a portal that flags anything that might have slipped through.
AlertRx is designed to scale, with the ability to add unlimited rules, which makes it adaptable across provinces, drug plans and billing systems.
A big win for pharmacists (and taxpayers)
Since launching less than a year ago, AlertRx has already made a measurable impact.
“We’ve done some analysis,” said Fadi Mesiha, AlertRx’s COO. “The average corrected claims for a pharmacy using AlertRx is about $6,000, and we’re charging a fraction of that.”
By catching billing mistakes early, the software helps pharmacies avoid audits and clawbacks. This saves money for pharmacists and reduces unnecessary strain on public health-care funding.
“That's what makes my day,” said Gobrail. “We’re hearing that it’s working, and that they’re happy with it.”
The platform also identifies profit loss related to pack size discrepancies and coordination of benefits billing errors.
Where tech meets tenacity
While still working full-time in pharmacy, Gobrail went back to school to earn a master’s in health informatics from the University of Toronto to bridge his expertise with tech.
“I felt that I needed to gain the extra knowledge to be in the health technology space,” he said. “Time and effort are of great value, and I’m very proud of where we are now.”
The team credits its success to a combination of experience, technical insight and relentless focus on solving a widespread industry problem.
Looking ahead
As AlertRx grows, Gobrail and Mesiha are leaning on support from innovation partners like Innovation Factory and Communitech.
“We’re preparing for our next phase, finding investors, expanding the platform,” said Riad. “We’re proud to be building a product that supports pharmacists and empowers them to better serve people across Canada.”
“Avoidable billing mistakes are the last thing we want to be spending money on,” said Gobrail. “This is about protecting the system.”
