Background
Section 6002 of the Deficit Reduction Act requires all ambulatory care providers, including any outpatient departments of hospitals, who bill Medicaid for outpatient administered pharmaceuticals to include the correct 11 Digit National Drug Code (NDC) on all applicable claims submissions.
Updated to Match Changing Codesets or Guidelines
Our products subscribe to a variety of industry standard and government databases, and are automatically updated as appropriate based on changes to code sets (HCPC code sets are updated quarterly) or guidelines.
Reduce Your Workload
Tying dispensation activity to pharmacy wholesaler invoices is impossible to perform manually. By removing the intense workload burden required, we also free up time for users to address other areas of concern in pharmacy operations.
Improve Your Billing Operations
The DRA Tool™ improves your billing operations by providing full visibility into your pharmacy operations. Wholesaler invoices are clearly matched to dispensations, and instances where codes have been omitted, modified, or identified as inconsistent are documented and users alerted.
Enjoy the Only Comprehensive Solution
Our solutions address the challenge of reporting the correct NDC to the correct payer in either the hospital ambulatory care setting or the outpatient retail pharmacy. Our solutions follow the Policies and Procedures of your particular environment and automatically perform the tedious operation of adding NDCs to claims as necessary.
Sentinel RCM™ provides the DRA Tool™, which scans 837 claims, applies the correct NDC, quantity, cost, and documents compliance.
Too Many NDCs, Too Little Time
The reporting requirements of Section 6002 of the Deficit Reduction Act impose a significant challenge to hospitals across the country. Now hospitals must track thousands of NDCs for thousands of codes, in addition to delivering quality care to patients. The operational challenges posed are significant and involve detailed communication between finance, billing, and pharmacy departments and systems.
Other Solutions Leave You Vulnerable to Costly Audits
Our products document compliance according to specific Policies and Procedures and match all purchases to all claims submitted. This detail is preserved and can be audited online with just a few clicks. If exceptions occur, they are documented, the appropriate users are alerted and the exceptions are held for review.
