Prescription Drug Claims Reimbursement Optimization: AWP Resubmission Services

Third-party pharmacy claims reimbursement is accurate – and automated – with average wholesale-price monitoring of drug prices.

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With pharmacy claims reimbursements continually declining, it's important for your pharmacy to optimize prescription 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third-party transactions where the average wholesale price (AWP) has increased on prescription drug claims paid using outdated AWPs. We monitor – and notify your pharmacy – when an AWP price change has occurred and a payer has paid a claim using an old AWP.

An effective way to optimize pharmacy claims reimbursement

Here’s how AWP Resubmission Services works for your pharmacy:

  • Once a payer updates its drug pricing file, you receive a report showing opportunities for optimizing your reimbursement by reversing and resubmitting the claim.
  • Using this report, you review, reverse and resubmit the non-current AWP claims to help recoup the additional revenue.
  • With the Online Resubmission option, we automatically reverse and resubmit drug claims you’ve selected as AWP opportunities, making it even easier to help recover the price difference.

AWP Resubmission is just one of the pre and post pharmacy claims editing solutions available.

AWP Resubmission Services can help your pharmacy:

  • Optimize reimbursement accuracy from third-party pharmacy transactions.
  • Improve pharmacy efficiency and reduce resources required to monitor prescription reimbursements.

AWP Resubmission Services allow your pharmacy to:

  • Identify prescription drug claims paid using an outdated AWP.
  • Flag claims that show opportunities for increased prescription reimbursement.
  • Review and select claims to resubmit for higher drug reimbursement.
  • Access online reporting options for quick and easy management of claims reimbursement.