White Paper – Automated Controls for Medical Drug Spend

RJ Health has a new white paper available for download.

Automated Controls for Medical Drug Spend by RJ Health’s Chief Innovation Officer, George Herchenroether – Appropriate reimbursement for drugs covered by the medical benefit requires more data and structure than most medical claims or billing systems were originally intended to process. This applies even more so when the systems are proprietary.

As the field of medically covered drugs has expanded, Health plans are modifying systems and edits to adjust to the challenge. This requires an accounting for the complexity and variability of how medically covered drugs are grouped, coded, and priced.

In RJ Health’s most recent white paper, Automated Controls for Medical Drug Spend, you will learn about overcoming obstacles associated with medical benefit drug management such as:

  • Drug payment accuracy
  • Compliance with mandated data policies
  • Medical benefit drug pricing methodologies
  • New therapies and continual updates

Please click the following link to download the white paper:


If you found this information about medically covered drugs helpful, you may also like to view our recent webinar, Shedding Light on Medically Covered Specialty Drug Pricing Methods.

You may also browse our collection of white papers.