Reduce pharmacy claim submission errors and optimize reimbursements

Managing pharmacy prescription claims is a complex process, with numerous variables to monitor and dispensing system limitations. Failure to effectively manage prescription claims can result in suboptimal decisions, processing delays and inadequate reimbursement. Yet manually managing the clinical and financial variables in claims processing requires tremendous resources.

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Pre and Post Editing (PPE) Solutions from RelayHealth help to automate the critical elements of pharmacy claim adjudication. By providing actionable messages specific to each claim, PPE enables staff to make faster, more informed decisions that help improve revenue potential and productivity.

Powerful solutions to refine pharmacy claims management

PPE assesses each claim against dozens of parameters and delivers meaningful and actionable messages. This enables smoother processing and helps ensure optimal pharmacy claims reimbursement.

PPE reporting offers a web-based suite of reports regarding your use of pre and post edits. By enhancing the impact and value of PPE, you can make strategic decisions to refine your results even further.

Features of PPE:
  • Provides real-time pharmacy claims validation
  • Delivers meaningful and actionable messages to staff
  • Provides continual updates and new edits based on changing payer and industry requirements
  • Web-based reporting for comprehensive analysis
We can help:
  • Achieve optimal reimbursement potential
  • Reduce claim submission errors
  • Improve pharmacy staff productivity
  • Enable better strategic decisions for improved results