Although it only takes seconds to submit a pharmacy claim, the amount of information required for each claim creates dozens of potential roadblocks to receiving maximum reimbursement. Processing thousands of prescriptions each month, pharmacies are challenged to review each claim for inaccuracies or missing data. Pharmacies need to make corrections in the post-adjudication deadline window and reconcile claims after processing to reclaim missing reimbursement and ensure proper payment. Miss a detail in any of these steps and significant revenue can be lost.
Scriptmax is Innovatix’s new Web-based tool with the industry’s most complete support for pharmacy data analytics and adjudication services. Scriptmax offers a comprehensive suite of pre-edit, post-edit, and reconciliation services. The goal: enable pharmacies to receive maximum reimbursement by minimizing errors on prescription claims.
A Health Affairs study found that approximately 27% of Medicare Part D claims are rejected due to inadequate or incomplete data or invalid information. Another 39% of claims were rejected for a variety of administrative reasons.
With its three-phase suite of services, Scriptmax empowers pharmacies with actionable claims review data during every step of adjudication:
Real-time claim validation that maximizes reimbursement and minimizes rejected claims.
Sample pre-edit features include:
Timely feedback on submitted claims enables corrections within the post-adjudication window.
Samples post-edit features include:
Automates third-party payment reconciliation and contract rate compliance.
Sample reconciliation features include:
Scriptmax is a powerful tool that any pharmacy can use to streamline and optimize prescription claims. Its features include:
Scriptmax is a fee-based service and is open to any pharmacy. Users are charged per adjudicated claim, so you pay based on the number of claims reviewed. You do not have to be an Innovatix GPO member to use Scriptmax.
Stop leaving money on the pharmacy claims table. Start using Scriptmax today!