|
Core PSAO Services
+ Managed Care Contracting
Set your pharmacy business on a sound
footing. Reap benefits from our long-standing
relationships with regional and national health
plans as well as payers. Designed to enhance and
sustain dispensing revenue, our managed care
contracting program offers multiple chain codes
for access to those contracts that are best suited
to your needs.
+ Direct Contract Consulting
Line up emerging opportunities with your
strategic goals. Explore both traditional and non-traditional service contracts with expert advice.
Our contract review process comprises intelligent
data analysis and projection, evaluation of current
to proposed rates, and breakdown of COG and
overhead costs. Recommendations that arise
from the review process include what would be
an acceptable counter offer based on a thorough
analysis of contract rates.
+ The Quality Center
Maximize your ROI from patient interactions
and meet performance goals. Access a
personalized, web-based toolkit for actionable
insight into patient behavioral patterns. Key
features include a user-friendly dashboard, MTM
dashboard, and single sign-on access to EQuIPP®.
+ Compliance GUARDIAN
Build a culture of compliance and preserve
patient access. Maintain in-network status with
a customized web-based solution that offers
training modules on HIPAA Security and FWA; OIG
and GSA exclusion verification; and attestation
support. Having quick and easy access to
important documentation that shows proof of
compliance in the event of an audit can help you
avoid penalties.
+ ClaimGUARD
Maximize reimbursement. Reduce your
administrative burden with a solution for the
research, analysis, and submission of generic
MAC claims reimbursed below cost. Key features
include automated processes driven by claims
data and wholesaler invoice cost tables; flagging
of discrepancies between claims payment and
invoice cost; and monthly follow-up on your behalf
with PBMs to improve response rates.
+ Central Pay
Maintain a steady stream of cash flow.
Conveniently aggregate payments and boost your
cash flow with a centralized program for efficient
reimbursement. Our differentiated program
operates on a same-day payment policy so that
all funds received from a payer on a given day
are disbursed on that same day, ensuring that you
have sufficient cash on hand.
+ True Script Reporter
Save time with custom reporting on
reimbursement data. Keep track of aggregate
payments as well as your electronic remittance
advice (835) files with the help of an easy-to-use,
web-based reporting platform. You can adapt and
utilize exportable report options to support your
financial reporting.
|
Additional PSAO Services
+ Claims Reconciliation
+ eRecon
Leave no money on the table. Our automated
claims reconciliation and accounts receivable
solution saves you time to focus on patients.
This industry-leading solution that combines
technology and live, U.S.-based customer support
to deliver tangible results. Key features include transaction-based
accounting, manual remit assistance, and a chase
feature for missing payments.
+ EnsurePay
Approach each reimbursement cycle with
confidence. You can effectively manage your
reimbursement data to increase accuracy
and reduce processing time with our 835-file
management program. Elect to have 835 files
provided to a reconciliation vendor of your
choice and/or uploaded into pharmacy operating
software with certain vendors.
+ Audit Protection
+ RxProtect
Safeguard your investment. Gain peace of
mind from knowing that you can take proactive
steps to identify your pharmacy’s audit risk and
minimize financial liability. Our multi-level program
combines education, claims review, and real-time consultation services to deliver an all-in-one
solution for protecting your bottom line. Key
features include audit tips, technician training,
onsite audit* assistance, high-risk claims report,
and audit/appeal support including hard copy
review.
+ Clinical Services
Establish a blueprint for excellence. Explore
opportunities to boost revenue by monetizing
your clinical expertise. Our clinical program goes
beyond dispensing to offer pioneering approaches
for improving clinical outcomes. Key features
include a CPESN participating pharmacy network
for clinical services, local and regional revenue
opportunities, COVID vaccine network, RxEvolution
participating network, adherence metric support,
and DIR fee mitigation.
|