Retail: Reimbursement Solutions
Research has revealed that most pharmacies do not have the time or resources to spend on third party reimbursement. To alleviate this time consuming task, H. D. Smith's Third Party Network provides assistance on behalf of pharmacies. The Third Party Network helps maximize profits, improve cash flow and level the playing field with third party payers by providing the tools necessary to ensure pharmacies are being paid the correct amount on each claim.
Reimbursement Solutions
Third Party Network
The Major Value Third Party Network is an essential program of H. D. Smith, with a long-established record of partnering with healthcare plans and pharmacy benefit managers. The Third Party Network contracting manager acts as a liaison between the pharmacy and the healthcare plan, arranging procedures and negotiating. With the voice of over 1,000 stores, the Third Party Network has the negotiating power to provide the most comprehensive rates and services. Through communication and negotiation, the Third Party Network works hard to deliver solutions to everyday pharmacy needs, enabling pharmacies to stay highly competitive in this growing industry.
Reimbursement Announcements
Announcements
- Express Scripts Tricare System Downtime 3/15/10
- Mirixa MTM Sign-up Document 3/9/10
- Prescription Solutions Pantoprazole Processing 3/9/10
- Hernandez Settlement Agreement 3/9/10
- Medicare Part D Formulary Change 3/5/10
Medicare Part D News
- Medicare Prescription Drug Coverage & Your Rights 10/22/09
- Fraud, Waste & Abuse Training Recommendations 10/22/09
- Medicare Fraud, Waste & Abuse Attestation Statement 10/22/09
Reconciliation
H. D. Smith offers the only reconciliation program in the industry that not only reconciles prescriptions electronically but also chases underpaid and unpaid claims. Our Third Party Network Reconciliation Program verifies payments electronically to ensure pharmacies are paid according to the agreed amount from adjudication. Discrepancies are listed in real time on an online web portal, so pharmacies know exactly what is owed and from whom.
The Reconciliation Program automates transaction-level reconciliation for pharmacies, saving time, increasing accuracy and ensuring correct compensation from third party payers. In addition, the Reconciliation Program automatically compares pharmacy data to electronic remittances, creating a detailed claim adjudication summary. The end result is a cost-effective, accurate process that provides pharmacies the peace of mind that all funds are being collected, missing checks are tracked and payments are distributed correctly.
Profit Optimizer
Gain peace of mind and a more profitable operation with the Profit Optimizer program. A dedicated pharmacy-experienced analyst works directly in the pharmacy system through a secure connection. The analyst diligently re-bills erroneous transactions, adjusts brand and generic pricing and makes other adjustments to optimize future transactions. Furthermore, the analyst investigates and resolves billing errors.
Each pharmacy is assigned a dedicated pharmacy analyst who seamlessly integrates within the existing pharmacy infrastructure, reducing labor requirements by creating a tool consistently focused on increasing bottom line revenue.
Price-It
Price-It utilizes a traditional third party switch network to deliver real-time cash pricing consistent with local competition. Prices on all cash drugs are determined through a comprehensive market review performed by a professional analyst. In addition, the analyst has a consultation with the pharmacy to establish the core business drivers. Creating uniform, competitive pricing resulting in higher consumer confidence, Price-It reduces labor, maximizes profits and ensures the highest possible reimbursement on third party transactions.
Price-It analysts work with pharmacies to create a customized revenue enhancing program from the following tools:
- Real-time custom cash pricing on over 1,200 drugs based on the local market
- 30-Day Match-It program in response to $4 programs (available with custom pricing)
- 90-Day, 100-Day or 120-Day Plans with custom pricing
Contact Third Party Network
Contact the Third Party Network at 866.429.7747 or .