Third-party Pharmacy Solutions

Spending too much time and too many resources managing your third-party pharmacy receivables?

Not able to easily benchmark your A/R management status and performance?

Not confident you are receiving an accurate accounting, reconciliation, and reporting of reversals, coordination of benefit claims, recoupments, and overpayments with your current process?

Then it is time to launch PRISM Spectrum

Flags exception records for re-work, reclassification or write-off

Provides exception-based, workflow tools through a secure, web portal to deliver front-end controls to users -- both standard and ad hoc/custom reporting are available to focus collection efforts

Delivers an accurate accounting, reconciliation, and reporting of reversals, coordination of benefits claims, recoupments and overpayments

Provides comprehensive matching for lowest unapplied cash (<1%) in the industry -- reports on remaining unapplied cash in up to 33 separate categories to help resolve issues

Drills down to claim detail for user to see claim status, general script-level information, transaction history, store information, notes, split-bill relationships, etc.

Access to benchmark data such as service fees, DSO, number of payers, percent of electronic remittance, payer exceptions, unapplied checks, tolerances, write-offs, and found money to evaluate your A/R management status and performance

Retains closed claims live on the PRISM system for 15 months after date of last activity and archive for 10 years -- facilitates OIG and PBM audit reviews

Works with any switch or dispensing data feed -- the PRISM A/R solution offers flexibility and connectivity with a retailer’s existing pharmacy system or switch/clearinghouse