Core PSAO Services
+ Managed Care Contracting
Set your pharmacy business on a sound footing. Reap benefits from our long-standing relationships with regional and national health plans as well as payers. Designed to enhance and sustain dispensing revenue, our managed care contracting program offers multiple chain codes for access to those contracts that are best suited to your needs.
+ Direct Contract Consulting
Line up emerging opportunities with your strategic goals. Explore both traditional and non-traditional service contracts with expert advice. Our contract review process comprises intelligent data analysis and projection, evaluation of current to proposed rates, and breakdown of COG and overhead costs. Recommendations that arise from the review process include what would be an acceptable counter offer based on a thorough analysis of contract rates.
+ The Quality Center
Maximize your ROI from patient interactions and meet performance goals. Access a personalized, web-based toolkit for actionable insight into patient behavioral patterns. Key features include a user-friendly dashboard, MTM dashboard, and single sign-on access to EQuIPP®.
+ Compliance GUARDIAN
Build a culture of compliance and preserve patient access. Maintain in-network status with a customized web-based solution that offers training modules on HIPAA Security and FWA; OIG and GSA exclusion verification; and attestation support. Having quick and easy access to important documentation that shows proof of compliance in the event of an audit can help you avoid penalties.
Maximize reimbursement. Reduce your administrative burden with a solution for the research, analysis, and submission of generic MAC claims reimbursed below cost. Key features include automated processes driven by claims data and wholesaler invoice cost tables; flagging of discrepancies between claims payment and invoice cost; and monthly follow-up on your behalf with PBMs to improve response rates.
+ Central Pay
Maintain a steady stream of cash flow. Conveniently aggregate payments and boost your cash flow with a centralized program for efficient reimbursement. Our differentiated program operates on a same-day payment policy so that all funds received from a payer on a given day are disbursed on that same day, ensuring that you have sufficient cash on hand.
+ True Script Reporter
Save time with custom reporting on reimbursement data. Keep track of aggregate payments as well as your electronic remittance advice (835) files with the help of an easy-to-use, web-based reporting platform. You can adapt and utilize exportable report options to support your financial reporting.
Additional PSAO Services
+ Claims Reconciliation
Leave no money on the table. Our automated claims reconciliation and accounts receivable solution saves you time to focus on patients. This industry-leading solution that combines technology and live, U.S.-based customer support to deliver tangible results. Key features include transaction-based accounting, manual remit assistance, and a chase feature for missing payments.
Approach each reimbursement cycle with confidence. You can effectively manage your reimbursement data to increase accuracy and reduce processing time with our 835-file management program. Elect to have 835 files provided to a reconciliation vendor of your choice and/or uploaded into pharmacy operating software with certain vendors.
+ Audit Protection
Safeguard your investment. Gain peace of mind from knowing that you can take proactive steps to identify your pharmacy’s audit risk and minimize financial liability. Our multi-level program combines education, claims review, and real-time consultation services to deliver an all-in-one solution for protecting your bottom line. Key features include audit tips, technician training, onsite audit* assistance, high-risk claims report, and audit/appeal support including hard copy review.
+ Clinical Services
Establish a blueprint for excellence. Explore opportunities to boost revenue by monetizing your clinical expertise. Our clinical program goes beyond dispensing to offer pioneering approaches for improving clinical outcomes. Key features include a CPESN participating pharmacy network for clinical services, local and regional revenue opportunities, COVID vaccine network, RxEvolution participating network, adherence metric support, and DIR fee mitigation.