Pre and Post Editing Solutions for Pharmacy Claims Processing

Reduce pharmacy claims submission errors and optimize reimbursement with actionable messages during pharmacy claims processing.

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

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Managing pharmacy prescription claims is a complex process, with numerous variables to monitor and drug dispensing system limitations to consider. If your pharmacy staff doesn’t effectively manage pharmacy claims adjudication, you could face processing delays and incomplete reimbursement. And yet manually managing the clinical and financial variables in claims processing requires tremendous resources.

Maximize pharmacy claims reimbursement accuracy

Pre and Post Editing Solutions assess each claim against dozens of parameters and deliver meaningful and actionable messages. These messages result in smoother processing, helping to 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 pharmacy claims processing even further.

A pharmacy claims tool that brings results:

  • Realize your pharmacy’s optimal reimbursement potential
  • Reduce claim submission errors
  • Improve pharmacy staff productivity and efficiency
  • Enable better strategic decisions

Manage pharmacy claims efficiently and effectively:

  • Real-time pharmacy claims validation
  • Meaningful and actionable pre and post editing messages to staff
  • Continual updates and new claim edits based on changing payer and industry requirements
  • Web-based reporting for comprehensive analysis