Streamline and accelerate claims payments
There’s no understating the impact that delayed or denied claims can have on your organization’s bottom line. Claims Manager Plus is a SaaS solution designed to help you accelerate payment for pharmacy claims and minimize claim denials, while managing complex, government-mandated reporting requirements.
The solution’s sophisticated rules engine streamlines the adjudication process by automatically modifying claims based on your configurations, flagging errors and rejections, then re-validating with real-time edits you make directly in the application. Further, your modifications are incorporated back into Claims Manager Plus so future claims will adjust correctly without manual intervention, continually reducing the percentage of rejected claims over time. Claims Manager Plus helps your organization:
Manage 340B reporting requirements for Medicare and Medicaid
Process claims quickly and efficiently while remaining compliant and in control of changes
Reduce delayed, denied and unpaid claims with dynamic configuration logic
Automatically adjust pharmacy claims based on any number of rule sets
Edit NDC codes, modifiers, and prices on demand, directly in the platform’s workflow
Link NDC charge information to current drug purchases
Common pain point
The rules governing claims submission have gotten more and more specific, and most hospitals don’t have the IT systems in place to submit claims that contain accurate, charge code-specific NDCs and acquisition cost data.
Our Claims Manager Plus solution updates pharmacy claim line information based on rule sets you choose, helping to expedite time to reimbursement.
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