Increase Profitability


Description

In today’s pharmacy climate, it is critical to ensure maximum third party claim reimbursement while minimizing billing errors and potential audit risk.

Inaccurate pricing, incorrect quantities, outdated NDC’s, etc. all of these can significantly impact your bottom line. However, carving out time on a daily/weekly basis to review third party billing reports, claims analysis including billing issues, can be challenging - to say the least.

These are just a few of the third party billing issues as to why we created:

RECLAIM Rx Offers:

  • Data analysis using market intelligence combined with industry knowledge.
  • Reports - but not just reports waiting for review. Yes, we supply claims reporting, but our “A Team” reviews claims data specific to individual stores for savings opportunities and Profit increase to you.
  • Proactive communication and customer outreach.
  • Pre & Post Edits (PPE) - a superior edit service applying real-time logic to maximize reimbursement with AWP Pricing, Obsolete NDCs, Standard Dispensed Quantity, Proper DAW Codes, and Auto-Resub.

Auto Resub

Saving our Customers $14 or more per eligible claim!!!

Automated resubmission service designed to maximize third-party claim reimbursements by identifying claims that have been paid based upon outdated AWPs. Rx Linc Professionals monitor claims for greater opportunity and apply best-practice analytics to our oversight of your opportunities. Weekly reports are generated and emailed to you identifying the weekly activity of savings.


AWP Update

Maximizes revenue by updating claims (in real-time) to the most up-to-date (daily) AWP without requiring any action by the pharmacy.


DAW Verification

Ensures the most appropriate DAW code is being submitted to mitigate audit risk as well as the potential for reduced reimbursement.


Standard Dispense Quantity

Catches the common, but costly, errors of submitting incorrect quantities for inhalers, solutions, and other packaged medications.

NDC Validation

Analyzes each claim to identify outdated NDCs and provides an updated replacement NDC where available. PBM's typically reimburse lower on outdated NDC’s.