Category Archives: Webinar

In Medical Drug Edit Blog Posts #1 & #2, we learned how Medical Drug Edits can enhance Medical Drug claim submission and reimbursement accuracy.  However, the utilization of an API (Application Programming Interface) to deliver Medical Drug Edits can further improve the Medical Drug pre-claim review process. Specifically, the use of an API can: Speed […]

RJ Health’s Saas provides data regarding the number of billable HCPCS code units that are associated with each NDC. Learn more: VIEW THE FULL WEBINAR   [TRANSCRIPT] Laura: First, we’d like to do a quick orientation to some of the applicable data. We will assume that you have some basic knowledge about medical claims, and we’ll […]

As drug spend increases, so does the use of genetic tests. How does this affect claims processing? Watch to learn more: VIEW THE FULL WEBINAR [TRANSCRIPT] So, the next question that we often hear from our clients is great, don’t need to worry about this on the pharmacy benefit, medical benefit, so what we did […]

Of about clinical 1,400 studies, 34% were tied to some sort of genetic test. This will only increase over time. Watch to learn more: VIEW THE FULL WEBINAR   [TRANSCRIPT] Now, the other piece is, okay, great, so we have these 27 products, pretty small compared to the hundreds or thousands of products that we’re […]

Today there are 27 drugs that have been approved by the FDA that have genetic companion diagnostics tied to them. Genetic-defined therapies are becoming more prevalent in many cases. Although not the case with every therapy, there is definitely a trend with drugs requiring genetic tests having a higher cost per treatment. Watch to learn […]

  The pace of advancement in genetics and precision medicine is staggering. Today, there are more than 75,000 genetic testing products on the market, and more than ⅓ of therapies in the development pipeline are for molecularly-defined conditions. In this webinar, experts in genetic testing, drug spend, and claims payment automation will provide practical insight […]

  Below is the transcript from our On-Demand Micro-Webinar: Where is my NDC? Powered by ReimbursementCodes.com Laura:  Welcome, and good day.  Thanks for joining us.  Today we would like to help you by answering the most frequently asked question about RJ Health Data; Where is my NDC? I’m Laura, Clinical Informatics  Pharmacists with RJ Health, and joining […]

Whether the product comes in a single or multi-dose vile can also affect billing units. In this example, there is one billing unit contained in a single-dose vial, and 10 billing-units are contained in a multi-dose vial. In this case, it is helpful that the NDCs cross-walk back to different codes. Conversion factors are often incorporated […]

You have to take into account multiple considerations based on the NDC that is being billed, such as the dose for a pediatric patient billed differently from an adult dose, so each may crosswalk to a unique code. Whether the NDC designates a single dose or a multi-dose vile could affect the unit conversion.   […]

When we are dealing with code level data, important basics include the billing of the correct units and making sure that you are billing under the correct code. For this year, seven brands of quadrivalent vaccines are available, but due to different properties including dose, 28 individual NDCs crosswalked back to 9 different codes.   This […]