Pharmacy
Pharmacy
To view an online demo of PHARMauditor™, CLICK HERE
With MedLearn’s help you can maintain a correct and compliant Pharmacy Chargemaster. Through PHARMauditor™, you have a reliable resource to identify CDM vulnerabilities and get clear advice from MedLearn's coding and reimbursement experts. Other proven benefits include
• Appropriately capture pharmacy revenue
• Achieve precise mapping between Pharmacy System and CDM
• Ensure that HCPCS and Revenue codes are assigned for all NDCs
• Ensure correct descriptions and dosages are reflected in CDM and Formulary
• Maintain current and valid NDC numbers
• Ensure accurate billable units, package size and package quantity for NDC
• Evaluate current price relative to AWC and WAC cost X regional or other mark-up and APC rates
• Reduce your RAC risk
• Quickly search by drug name (brand or generic), HCPCS or CPT code, NDC number, ICD-9-CM code or Therapeutic Class
CLICK HERE to view a demo of PHARMauditor
MedLearn Approach
Our approach encompasses a documentation review as well as a comprehensive analysis of charge capture processes and CDM validation using the NDC database which also powers the MedLearnDrugCodes.com site. Our focus is ensuring accurate charge capture, claims processing and receipt of accurate payment. It is critical to not miss charges or under or over record billing units.
Audit Process
Using PHARMauditor, you upload your Pharmacy CDM and NDC file with service codes, descriptions, costs and more. The system automatically performs a comprehensive assessment to provide the information you need to ensure accurate and complete revenue codes, HCPCS/CPT codes, billing units, national drug codes, descriptions and average wholesale pricing.
MedLearn experts are available to help you migrate the pharmacy data file directly into your pharmacy chargemaster.
Audit Deliverables
PHARMauditor deliverables include analysis reports that identify priority issues, implementation tools, and access to MedLearn expertise. This includes meetings with department managers to identify root causes of non-compliant or ineffective charge capture methods.
You receive a detailed audit report describing:
• Financial Impact/Compliance Vulnerabilities – estimated annualized revenue opportunity or potential compliance risk
• Priority Items – significant revenue, compliance and educational opportunities all classified with our 30-60-90 Day Implementation Priority Index
• Significant Technical Findings – department-level detail zeroes in on "must do" recommendations
• Pharmacy CDM Implementation Reports – simple reports detail line item recommendations and supporting regulatory rationale
• Online Access to PHARMauditor – so you may sustain compliant revenue streams, update your pharmacy CDM and research regulatory coding issues through a secure web-based application
CLICK HERE to view a demo of PHARMauditor
For more information please contact Jennifer Ramthun, CDM Coordinator, at 1.800.252.1578, ext. 3429.
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