Introducing RC Claim Assist (Releasing in September 2016)

There is a growing trend in physician administered drugs submitted to the medical benefit. Billing at the NDC unit is becoming the new standard. While the use of an NDC has long been a requirement for many payors, it is becoming more prominent for physicians to now include the NDC Billable unit.

After conducting a recent survey with our payor clients, nearly 50% are addressing the use of NDCs for various reimbursement metrics. This NDC initiative requires a comprehensive approach from developing policies, databases and most importantly through provider education.

Source: RJ Health Payor Survey, March 2016
Source: RJ Health Payor Survey, March 2016

Physicians may be unclear of how to submit the correct NDC billable units. Likewise, payors may lack the resources to demonstrate the conversion from HCPCS/CPT code level units to the appropriate NDC units. Ultimately, a consistent process helps both groups drive towards operational excellence and supporting the revenue cycle.

RJ Health has created RC Claim Assist as the single solution for both groups. A web-based application, RC Claim Assist is designed to help providers through the conversion process to ensure the correct HCPCS/CPT Code, NDC and NDC Units are submitted on a claim. This means a reduction in claim errors during the adjudication process and fewer claims under appeals review.