Invoice Screening™
Invoice Screening™ targets Providers, Physicians, and Pharmacies responsible for rejected claims that did not meet contract requirements preadjudication by use of the "Three C's":
- Collecting -dollars from inappropriately paid claims.
- Correcting - vendor claims processing mistakes.
- Controlling - provider "abuse".
Invoice Screening™ Samples [pdf]
Average savings for most clients (between 7-10%) are realized when pharmacy invoice amounts are verified and billing details are screened in the following key areas:
- Eligibility
- Pricing
- Invalid Claims
- Benefit Exclusions
- Formulary Compliance
Oversight and management of vendor claims adjudication "real time" puts control and money back into your pocket with:
- Turn-Around-Time (TAT) within 72 hours of receipt of the data/invoice to prevent payment on rejected items.
- Peripheral identification of MD's and Pharmacies responsible for outlier and/or potential "abuse".
For more information about these services or applicable rates
in your service area,
please contact Carol Stern @ 818-701-5438 or carol.stern@propharmaconsultants.com
 |
 |