Category Archives: Product Updates

Increasing healthcare costs continue to outpace inflation in the United States. Specialty drug costs are the largest driver and component to healthcare spend. This surge has led to transformative patent care but has also given rise to a disproportionate total healthcare spend. Major drivers of medical drug spend are the complex processing of medical drug […]

INSIDE THIS ISSUE CMS News Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information Software Updates Prioritize your Code Level Pricing CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. Of the 35 […]

In Medical Drug Edit Blog Post #1, we saw that pre-payment edits of Medical Drug claims can be utilized to improve claim submission and reimbursement accuracy.  Payors and providers license RJ Health’s Medical Drug Edits and access them via our API platform. This is because effective pre-payment review of medical drug claims requires: •  The […]

Drugs covered under medical benefit plans and their costs are difficult to manage. These challenges are due to: •  Limited clinical visibility and control •  Unaccommodating medical claims and claim systems •  Complex billing and reimbursement requirements related to coding and pricing As a result, medically covered drug claim errors are almost the norm.  In […]

In an effort to contain growing healthcare costs, Congress enacted the Omnibus Budget Reconciliation Act of 1990 (OBRA’90) and created the Medicaid Drug Rebate Program. Pharmaceutical manufacturers’ participation in the program became a prerequisite for Medicaid coverage of outpatient prescription drugs.Since then, states have been required to collect associated drug rebates to receive federal funding […]

Starting on January 23rd, when you visit ReimbursementCodes.com, you will see a brand new website. When you login to your account at the top of the page you will still be directed to the classic ReimbursementCodes website. This new public site will give you a taste of the new ReimbursementCodes experience coming in the next […]

Having personally dismissed 99% of these CEO missives, I wrestled with the need, never-mind the value of this communication. My objective since taking the reins of RJ Health in 2015 has largely been to distinguish us from the jargon-filled, oftentimes frenzied industry heavyweights we operate alongside in service to Payors and Providers in the Medical […]

Having personally dismissed 99% of these CEO missives, I wrestled with the need, never-mind the value of this communication. My objective since taking the reins of RJ Health Systems in 2015 has largely been to distinguish us from the jargon-filled, oftentimes frenzied industry heavyweights we operate alongside in service to Payors and Providers in the […]

A few weeks ago, we launched our brand new ReimbursementCodes website. The new site is intended to change the way our customers work by opening up all of our data sets, displaying the data in a user-friendly single-screen format, and incorporating tools that save time and ‘clicks’ like global search and calculators. So, we were […]

RJ Health and its flagship product – ReimbursementCodes – is renowned in the healthcare industry for its comprehensive, specialty drug database. For years, the ReimbursementCodes.com site has been the default resource for provider, payor, pharmacy and finance teams to address the constantly changing environment of coding and pricing for injectable drugs. Available now, we have […]