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Accurate Claim level reconciliation
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Physician Receivables Management
Pharmacy Receivables Management
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Home » Services » Pharmacy Receivables Management » Services Approach


Services Approach

Tranquilmoney has developed extensive processes and technology to manage pharmacy receivables for small and large clients. We have developed systems to work with electronic and paper input.

PharmTracker™ is Tranquilmoney's solution for pharmacy receivables management.

Typically Claims are received as text files. Payments are received as remittance advices (RAs) in the NCPDP or 835 format and on paper from some pharmacies. Check copies are received on paper.

Tranquilmoney scans paper and (1) enters it into the system for follow up and (2) archives images for later retrieval if required. Electronic claim files are simply imported into PharmTracker™.

Paper is scanned onshore, whereas the data capture, processing reconciliation and AR follow up is done offshore. Processing involves capture of data from paper and EDI files, matching claims with payments, applying reversals of claims and payments, processing of fees and adjustments based on payer specific rules, matching checks with RAs, research and follow up on mismatches.

Scanned Payments,Batch and import, Key verify and Correct,Reconcile checks & RA's, Import into database, Match each claim & payment, Exception processing, All data displayed online, Weekly reports sent to customer, Electronic payments, claims

Clients can see standard receivables management reports such as historical delinquency, aging, unapplied cash and custom reports in PharmTracker™. It is possible to search online for specific claims, payments and checks, which allows the Pharmacy to know status and pursue a claim if required.

Output for the client includes a list of all records that are new or modified, in the format specified by them for import into their system.

 

Related Reading

Case Study: Claims reconciliation and receivables management for a Pharmacy Chain, 47 Kb

White paper: Emerging from the black hole – perfecting pharmacy claim level reconciliation, 47 Kb

Brochure: Pharmacy Receivables Management services, 28 Kb

 
         
 
 
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