Services Directory: Pre- and Post-Edits
Automates critical elements of claim adjudication by providing actionable messages specific to each claim. It offers a web-based suite of reports regarding the use of PPE and offers Core PPE, including AWP comparisons; DAW appropriateness for multisource brands; U&C market comparisons; quantity/days’ supply; Medicare verifications; Drug Enforcement Administration (DEA) authentications; NDC validations; and quantity/package size and National Provider Identification (NPI) validations.
For more information, or to enroll, visit www.relayhealth.com.
eRx Edit by eRx Network® (formerly Change Healthcare™)
Provides a real-time pre- and post-editing (PPE) solution that comprehensively improves the pharmacy’s third-party reimbursements and in-store productivity. It contains a series of edits that provide financial, administrative and legal compliance reviews on prescriptions prior to being sent and received from the processor and offers a Market Usual & Customary (U&C) feature that compares U&C pricing to area competitors, providing pharmacies with valuable information for evaluating their retail pricing. It features online reports in near real-time for easy business analysis.
For more information, or to enroll, visit www.erxnetwork.com.
Cardinal Pre-Adjudication Edits
Provides a real-time solution designed to enhance efficiencies, protect margins and improve third-party reimbursements. It offers a series of edits that evaluate prescription claims and provide financial, administrative and legal compliance reviews prior to being sent to the processor and standard edits, including Average Wholesale Price (AWP) pricing updates, enhanced Dispensed-as-Written (DAW) code validation, standard dispense quantity checks and discontinued National Drug Code (NDC) alerts.
For more information, or to enroll, visit www.cardinalhealth.com.