Tag Archives: white paper

$35 billion of drug-related revenue comes from healthcare provider offices. Health plans have established policies that require additional information, not just the HCPCS code. This additional information enables payors to differentiate between drugs that exist under the same billing codes. Recent claims analysis revealed a high degree of confusion from providers on what is required […]

  Is your organization ready to recapture some of the $3 Billion lost each year to drug wastage? Have single-dose vials, dose, and waste, created a reimbursement challenge? What is drug wastage? How does drug wastage occur? What is the size and scope of drug wastage? Who does drug wastage impact? How can drug wastage be addressed? […]

Our latest white paper demonstrates the value and versatility of an automated medical drug claim edits solution. RJ Health’s system implements a rules-driven platform to reduce overall medical drug claims errors and improve overall efficiency. Appropriate reimbursement for drugs covered by the medical benefit increasingly requires more data and structure. Many of the billing systems […]