NewswireToday - /newswire/ -
Northridge, CA, United States, 2009/02/06 - Effective January 6, for entire 1Q of 2009 claims and billing professionals are able to submit no more than 1000 claims in electronic data format and receive a “Quick Rx Claims Screen” Report to evaluate.
Pro Pharma Pharmaceutical Consultants, Inc., a pharmaceutical consultant organization which focuses on data analytical expertise, announced today that the Invoice Screening™ Report is now available in quick, short form layout - “Quick Rx Claims Screen”. Effective January 6, 2009 for entire 1Q of 2009 claims and billing professionals are able to submit no more than 1000 claims in electronic data format and receive FREE of charge a “Quick Rx Claims Screen” Report to evaluate.
Pro Pharma has developed Invoice Screening™ Report “Quick Rx Claims Screen” to assist Providers, Physicians, and Pharmacies with management of rejected Rx claims that did not meet contract requirements pre-adjudication by:
1. Collecting dollars from inappropriately paid Rx claims.
2. Correcting Rx claims payment process of vendors.
3. Controlling provider “abuse”.
“Review of biweekly PBM Pharmacy Invoices for Preadjudication Claims could save you 10-15%", said Craig Stern, PharmD, MBA, President of Pro Pharma Pharmaceutical Consultants, Inc. “Savings for most clients are realized when Pharmacy Invoice Amounts are verified and Billing Details are screened in Formulary Compliance, Eligibility, Pricing / Mac Compliance, Invalid Claims and Excluded Benefits. Oversight and Management of Vendor Claims Adjudication “real time” puts control of money back into your pocket "
Benefits of Screening Invoices Every Two Weeks at Check Write Are:
• Turn-Around Time (TAT) is within 2-3 business days of receipt of the data, to prevent payment on rejections;
• Put Dollars Back in Your Pockets ASAP;
• Peripheral Identification of MDs and Pharmacies responsible for higher costs and/or for potential “abuse”.
Using standard NCPDP format Rx Claims data and invoices can be analyzed in the following key areas:
• Generic Switch Opportunities;
• Invalid DEA/NPI for Prescribers (Fraud savings potential);
• Invalid NDCs for drugs (Invalid re-pricing or bad prescribing);
• Generic Pricing Discrepancies (without MAC);
• Brand Pricing Discrepancies;
• Unrealized Opportunity Savings (Redbook).
In addition the following cost breakdowns can also be provided based on the same datasets:
• Weighted Average Rx drug pricing reports;
• Group price comparisons;
• Mail/Retail/OTC price comparisons.
Invoice Screening™ Report identifies areas to eliminate payment errors, categorize problems previously unidentified or historically not addressed, and puts money back in the employer pocket.
Pro Pharma seeks to help clients minimize their spending by pointing out opportunities for savings which are not commonly addressed by PBMs.
Every penny counts… Does your dollar make sense? Call and signup today for your FREE Invoice Screening™ Report “Quick Rx Claims Screen” today.
About Pro Pharma Pharmaceutical Consultants, Inc.
Pro Pharma (propharmaconsultants.com) is a multi-service, woman owned, privately held consulting firm offering a vast portfolio of services to public and private entities including self-insured employers, Taft Hartley Trusts and unions, public employers, for-profit hospitals and integrated health networks, health care insurance companies, worker's compensation insurers, small-to-medium sized HMO's, and physician groups.
As a primary service to plan sponsors for achieving below trend results, PRO PHARMA provides an integrated program of administrative process improvements, clinical quality oversight, and provider/member education.
PRO PHARMA’s Consulting services are grounded in the use of data and the communication of that information to define benefit trends, drivers and other analytical indicators. PRO PHARMA markets Biotech Modeling™, JCode Calculator™, Quality Management Program™, and Treatment Calendar™. The Company directly markets its products in the U.S. and collaborates with partners to reach international markets.