Optimize Drug Reimbursement
Ever-rising drug costs and ever-changing regulations likely make it difficult for your organization to receive proper reimbursement for the pharmaceuticals it administers, with the problem complicated by gaps in data moving between the systems that manage pharmacy purchases and patient billing. When pharmacy reimbursement codes are absent, incomplete, or incorrect, reimbursement will be denied, lowered, or delayed, and your hospital may increase its compliance risk.
What’s missing in your hospital’s reimbursement for drugs?
Pharmacy ChargeLink® solves these issues by ensuring that administered medications are accurately coded, billed, and reimbursed at an optimal level. By synching the drug purchase history and the chargemaster and addressing the gaps that cause revenue leakage, Pharmacy ChargeLink helps you identify revenue opportunities and create defensible pricing strategies. Its volume reconciliation tool compares the units purchased with the volume you’ve actually billed, to identify charge-capture problems and better manage potential compliance risks. Key features:
- Pharmacy ChargeLink detects codable drugs that are missing from the chargemaster, and identifies problems with billing units and route of administration. It alerts you when Medicare payments may not cover costs and identifies drug charges that are misaligned with your pricing strategies.
- Built-in workflow and change-management processes allow updates from pharmacy staff to be signed-off by reimbursement and pricing specialists. Recommended changes are integrated with the workflow approval process to increase efficiency and communication between pharmacy and finance staff.
- Pharmacy ChargeLink connects to the Micromedex® RED BOOK™ database for information and pricing data on prescription drugs and over-the-counter medications. This enables your staff to perform alternative-drug searches, benchmark pricing, and generate spend analyses and statistical summaries.
Pharmacy ChargeLink Implementation
Craneware Professional Services provides an implementation service that delivers a quick return on investment and ongoing benefits from using the software with expert consultation, best practices and effective business process design. The engagement includes a review and analysis of the previous 12 months’ pharmacy purchase history and of the chargemaster’s pharmacy data, onsite training, strategic reporting, and more.