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Many payors have incorporated policies for providers to inform payors on discarded or wastage amounts of drugs in single-use packages. To ensure appropriate reimbursement, the providers are required to submit two claim lines for the administered drug.  One claim line reflects the dosage administered to the patient and the second is for the wastage amount. […]

  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? […]

INSIDE THIS ISSUE CMS News New, Revised, and Deleted HCPCS® Effective July 1, 2019 Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information Software Updates Data Enhancements Coming Soon CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail […]

In May there were three new drug approvals by the FDA we deemed specific to the specialty market. In addition, there were 14 supplemental drug approvals. The FDA had acted on assignment of three new product reviews, although no PDUFA dates were published. Drugs included in this review are generally regarded by the industry as […]

INSIDE THIS ISSUE CMS News New, Revised, and Deleted HCPCS® Effective July 1, 2019 Upcoming in the June Update Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information Software Updates Data Enhancements Coming Soon CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or […]

In April there were four new drug approvals by the FDA we deemed specific to the specialty market. In addition, there were five supplemental drug approvals. The FDA had acted on assignment of new PDUFA dates for six new products for review. Drugs included in this review are generally regarded by the industry as specialty […]

Beginning April 29 and continuing to May 2, Asembia will be hosting its 15th annual Specialty Pharmacy Summit at Wynn & Encore in Las Vegas. RJ Health is excited to join the many pharmacies, health systems, pharmaceutical manufacturers, PBMs, health plans, technology companies, and consulting firms that will be in attendance. The agenda includes continued […]

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 […]

INSIDE THIS ISSUE CMS News New HCPCS® C-Codes Effective April 1, 2019 Now Available Quarterly ASP (Average Sales Price) Pricing File Revised for April 2019 April 2019 NOC (Not Otherwise Classified) Pricing File Hospital OPPS (Outpatient Prospective Payment System) Update Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information Software Updates Prioritize your […]

In March there were three new drug approvals by the FDA we deemed specific to the specialty market. In addition, there were four supplemental drug approvals. The FDA had acted on the assignment of new PDUFA dates for ten new products for review. Finally, there was one product that had an extension of a PDUFA […]