PRZOOM - /newswire/ -
Northridge, CA, United States, 2008/04/09 - PRO PHARMA, a pharmaceutical consultant organization which focuses on data analytical expertise, announced today that the enhanced Invoice Screening™ is now available to assist with Accounts Payable reviews of Health Plan, PBM and TPA invoices.
Specifically, Pro Pharma’s Invoice Screening™ will assist with management of rejected claims that did not meet contract requirements pre-adjudication by:
1. Collecting dollars from inappropriately paid claims
2. Correcting claims payment process of vendors
3. Controlling provider “abuse”
“Review of biweekly PBM Pharmacy Invoices for Preadjudication Claims can save you 10-15%", said Craig Stern, PharmD, MBA, President of Pro Pharma Pharmaceutical Consultants, Inc. “Savings for most clients are realized when Pharmacy Invoice Amounts are verified and Billing Details are screened against Formulary Compliance, Eligibility, Pricing/Mac Compliance, Invalid Claims and Excluded Benefits. Oversight and Management of Vendor Claims Adjudication “real time” puts control back into your pocket."
Invoice Screening™ eliminates payment errors, identifies problems previously unidentified or historically not addressed and puts money back in the organization’s pocket. Pro Pharma seeks to assist clients in minimizing their spend by identifying savings opportunities not commonly addressed by the PBMs. Pro Pharma will turn these reports back for management review/oversight/action within 72 hours after receiving complete data sets, to prevent payment rejections.
About Pro Pharma Pharmaceutical Consultants, Inc.
PRO PHARMA is a multi-service, woman owned, privately held consulting firm offering a vast portfolio of services to public and private entities including self-insured employers, Taft Hartley Trusts and unions, public employers, for-profit hospitals and integrated health networks, health care insurance companies, worker's compensation insurers, small-to-medium sized HMO's, and physician groups.
As a primary service to plan sponsors for achieving below trend results, PRO PHARMA provides an integrated program of administrative process improvements, clinical quality oversight, and provider/member education.
PRO PHARMA’s Consulting services are grounded in the use of data and the communication of that information to define benefit trends, drivers and other analytical indicators. PRO PHARMA markets Biotech Modeling™, JCode Calculator™ Quality Management Program™, and Treatment Calendar™. The Company directly markets its products in the U.S. and collaborates with partners to reach international markets.