Payer Auditing & Management

Is the pharmacy operating at peak performance?

How accurate is the pharmacies billing to payers?
How much potential revenue is being lost?

Resource Rx has partnered with an industry leader who provides a powerful data repository for advanced custom pre/post analytical services, audit, and a comprehensive reconciliation program.

But it doesn’t end there.

Your Value Proposition is their ability to measure and monitor claims during the adjudication process.

Services*

Benefits

Connectivity to all payers nationwide
Advanced pre/post business rules, edits, and analytics
Complete financial and claims reconciliation
Pharmacy recovery services
Data authentication and red flag edits
Forensic audit and collections
Formulary, CDM, and database services
Premium services and the ability to customize
Savings on switch fees
Reimbursement improvement
Improvement in net revenue
Automated workflow
Labor savings and effective utilization
Business analytics and automated audits
Recovery of lost and inaccurate revenue
Leverage existing HIS/PIS systems

With Resource Rx, you can leave the hard work to us. If you’re buried in paperwork, looking to streamline and become more efficient, and/or just worried about whether you’re billing and capturing your payments from payers correctly, talk to us. We can help.

Contact us today and find out how you can be the next great success story.

*Available to retail, nursing home, clinic, home infusion, mail order, closed door, hospital outpatient and independent chain pharmacies

Get Started Today