Automatically monitor prescription drug pricing changes

With pharmacy claims reimbursements continually declining, it's important for your pharmacy to optimize reimbursements whenever possible. AWP Resubmission Services help you capture lost dollars for third-party transactions where the Average Wholesale Price (AWP) has increased on prescription drug claims that were paid using outdated AWPs. RelayHealth monitors when an AWP price change has occurred and a payer has paid using an old AWP.

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Easily review pharmacy claims reimbursement opportunities to recover lost dollars

With our standard AWP Resubmission Services, you will receive a report – once the payer has updated their pricing file – that lists the opportunities where you can optimize your reimbursement by reversing and resubmitting the claim. Using this report, you can review, reverse and resubmit the non-current AWP claims to help recoup the additional revenue. With the Online Resubmission option, RelayHealth will reverse and resubmit those claims that you have selected as AWP opportunities online on your behalf, making it even easier to help recover the difference. AWP Resubmission is just one of many pre and post pharmacy claims editing solutions available from RelayHealth, designed to protect your pharmacy's margins and improve staff productivity.

Features of AWP Resubmission Services
  • Identifies prescription drug claims that were paid using an outdated AWP
  • Presents claims identified as opportunities for increased reimbursement in a report
  • Allows you to review and select which claims to resubmit for higher reimbursement
  • Even easier management via the online reporting options
We can help:
  • Optimize reimbursement accuracy from third-party pharmacy transactions
  • Improve pharmacy efficiency and reduce resources required to monitor reimbursements