One of the most difficult challenges of a pharmacy practice is understanding the contracts that are in effect, which govern the billing and prescription reimbursements due the pharmacy. ScriptPro has a valuable tool to help unravel this confusing process.
Third Party Management System – Contracts & A/R is designed and built for use by retail and institutional pharmacies operating in today’s healthcare market. This system is a management tool to oversee all aspects of contracts, third party billing, and collection of third party prescription reimbursements, including 340B prescriptions.
TPMS enables pharmacies to automate processing data pertaining to carriers that transact business with their stores. It facilitates matching claim and payment data and performs the business logic of applying payment to claims—allowing you to monitor compliance with contracts, reduce the risk of underpayment, and negotiate more profitable contract terms.
Third Party Contract Management
TPMS audits your third party contracts and alerts you to unfavorable contract terms, reimbursements, language, or upcoming changes that may affect reimbursement. TPMS advises you of issues to address during contract negotiations to maximize your reimbursement.
Third Party Accounts Receivable
TPMS imports claim data from the pharmacy management system and payment information from third party payers to manage payments and analyze the data against contracted terms. TPMS reports give you high level summaries by carrier, group, or plan, as well as detailed claim transaction data. The system detects the biggest payment discrepancies and margins and quickly notifies you of problem areas most likely to affect your bottom line.
More processes covered by TPMS are:
- Claim Automation
- Financial Reporting
- Analytical Reporting Package
To learn more about the power of TPMS for your business, Contact us.