Our splitbilling software for 340b covered entities offers superior compliance that is configurable to meet your organizations unique needs. Split billing contract pharmacy hospitals community health centers contract pharmacy our contractrx software helps covered entities and contracted pharmacies make the most of the 340b program. Effectively, this method identifies all of a ces op charge codes and uses them to identify drug. As a fundamental matter, determining whether a drug prescribed at a 340bparticipating hospital is considered a. The term split billing is used to describe this software, which splits a purchase order into two or three different accounts. Split billing is the process of separating the inpatient ip and op hospital charges from 340beligible. Sunrxs split billing solution virtually separates 340b, non 340b, and gpo purchasing transactions in mixeduse settings to help ensure patient eligibility compliance, thereby allowing hospitals to manage only one physical inventory for all drugs dispensed within the hospital. Userfriendly yet sophisticated, the 340b sm software helps approximately hospitals fulfill their mission to serve indigent patients while facilitating 340b tracking and management. Magdalena is a 340b subject matter expert with several years of experience in large dsh hospitals and hospital systems. As the covid19 pandemic continues to sweep the nation, many 340b stakeholders are curious about the implications for their 340b programs and any flexibility in program requirements that may emerge. The prime vendor has developed a number of tools to help covered entities operationalize 340b program compliance guidelines. Is eligibility identified within the splitbilling software, or through another data source like the admissions, discharges, and transfers. Her areas of expertise within 340b program implementation and management include.
You can untangle operational, financial and regulatory knots using our pioneering software and services. The system interfaces via edi with the hospital drug wholesaler, as well as. A lot of new ces dont have any tpa or split billing software in place when they golive with 340b. Using splitbilling software to simplify 340b ordering w. Mar 26, 2020 as the covid19 pandemic continues to sweep the nation, many 340b stakeholders are curious about the implications for their 340b programs and any flexibility in program requirements that may emerge. Hrsa issues policy release to clarify that certain hospitals dsh, childrens and freestanding cancer cannot buy covered outpatient drugs at. Poms paperless browser enabled medication and lab order management system.
This creates a risk for 340b drug diversion since these prescriptions may originate from ineligible locations. When considering an integrated solution that performs the splitbilling function for both hospital outpatient drug utilization as well as contract pharmacy. Our 340b architect software simplifies the complexities of managing a 340b so you can focus on the health of your patients and your organization. San diego, august 1, 2017 sunrx, a compliancefocused 340b contract pharmacy administrator, announced that it acquired eaudit solutions, which provides 340b software and services to hospitals, to offer covered entities an endtoend solution by adding splitbilling capabilities to 340b contract pharmacy management. Splitbilling decision checklist 340bpvp document repository. To manage a replenishment model, the entity tracks data feeds such as inpatient or outpatient status, patient and prescriber eligibility, clinic location, medicaid status, drug identifier, and quantity dispensed and sends these data into splitbilling software. Gpo prohibition group purchasing organization allows for collective negotiation by a group of providers certain hospitals dsh, childrens. Learn more about the benefits and challenges of a disproportionate share hospitals dshs 340b contract pharmacy and an outpatient pharmacy with maxor top. Paperless medication order management system for pharmacies nursing communciation workflow. Sentry data systems is a healthcare intelligence company, offering software applications to maintain 340b compliance, pharmacy management and contract pharmacy solutions. Adobe acrobat pdf 1 medicaid drug rebate program podcast series chris hatwig, vice president, apexus medicaid drug rebate program summit.
Getting started with 340b compliance an information guide. When i first understood this rule, i was flustered. The software must meet minimum requirements for 340b policy, such as preventing duplicate discounts and diversion. Compare and choose the best 340b management systems software for you. Coping with reduced 340b reimbursement for safety net. Verity solutions is both a pioneer and a leader in 340b split billing software solutions our robust featureset is flexible to meet and exceed the complex demands of our customers. How confident are you that your software is performing as designed. The term splitbilling is used to describe this software, which splits a purchase order into two or three different accounts i.
Verity solutions 340b program administration and compliance. Even with systems that can handle both billing methods, splitclaim billing is a process that doesnt get much love from software companies. The opa sent out the policy communication regarding the gpo exclusion and the split billing software practice on february 7th. These drug inventory and purchasing systems are distinct from hospitals patient billing systems and. Information management systems, including all 340b split billing software visit the maxor 340b program solution page to find out how to implement an onsite pharmacy to your location and extend your patient care. Sentry data systems the healthcare intelligence company. Virtual replenishment or splitbilling software attempts to automate purchasing between 340b, gpo and wac accounts many operational issues february 7, 20. The purpose of this tool is to list several key compliancerelated attributes to consider when evaluating, configuring, and maintaining split billing software. Backed by our sophisticated qualification engine, our splitbilling and contract pharmacy solutions lead the industry in compliance while maximizing savings. Most 340b hospitals dispense medications to both 340b eligible and ineligible patients. No, 340b hospitals have no restrictions based on a patients income, assets, ability to pay or medical criteria.
Our split billing software for 340b covered entities offers superior compliance that is configurable to meet your organizations unique needs. Sunrxs splitbilling solution virtually separates 340b, non340b, and gpo purchasing transactions in mixeduse settings to help ensure patient eligibility compliance, thereby allowing hospitals to manage only one physical inventory for all drugs dispensed within the hospital. For this reason, its prudent to have your split billing software ready to go at the same time your 340b registration is published. Split billing is the process of separating the inpatient ip and op hospital charges from 340beligible areas. Understanding key information technology concepts helps to. Macro helix 340b architect sentry sentinel verity solutions verity 340b. Splitbilling software vendor selection and setup considerations. Helping you simplify the complexities of 340b and minimize the cost. Prohibition and 340b comprehensive pharmacy services. If youre looking to maximize 340b drug pricing program participation, look to macro helix.
Oct 02, 2014 he has worked with clients on 340b projects for the past 15 years, planning and directing over 50 340b projects for health systems, acute care and childrens hospitals. Due to the complexity of their operations, the majority of the hospitals rely on split billing software to manage their drug inventory. Maintain a separate 340b inventory use a replenishment system splitbilling software. Getting started with 340b compliance an information guide for eligible entities page 1 apexus answers call center 340b prime vendor program 340b university 888. Our 340b architectsm software helps you minimize the challenges of running a 340b drug dispensing program so you can spend more time caring for your patients. Note that if the 340bsplit billing software is configured to identify a provider as always eligible, all orders and prescriptions from that provider will be identified as 340beligible regardless of the location. Split billing contract pharmacy hospitals community health centers. The purpose of this tool is to list several key compliancerelated attributes to consider when evaluating, configuring, and maintaining splitbilling software background.
Analyzes and oversee the utilization of technological solutions in place for 340b program facilitation e. Choose a partner that understands your 340b reality. Expanded flexibility for 340b stakeholders in the covid19. This creates a risk for 340b drug diversion since these. To manage a replenishment model, the entity tracks data feeds such as inpatient or outpatient status, patient and prescriber eligibility, clinic location, medicaid status, drug identifier, and quantity dispensed and sends these data into split billing software. Manager, pharmacy 340b program in pittsburgh, pa upmc. Nov 20, 2017 the software must meet minimum requirements for 340b policy, such as preventing duplicate discounts and diversion. Built on psgs marketleading qualification engine, order link is an easy to use webbased ordering and inventory management tool that drives productivity and optimizes 340b program value. All activity is then designated for proper replenishment, gpo, wac, 340b auditability and reporting. New years changes to the 340b discount drug program. Introduction gpo prohibition 340b inventory models virtual inventory process map split billing software function purchasing oversight roadmap.
We encourage all 340b hospitals to consider joining our association and look forward to working with our members in 2019 to protect this vital, lifesaving program. This software can help the entity place orders in appropriate accounts, which should support 340b compliance while still having only one physical inventory. Especially for any type of entity outside of dsh, childrens hospitals, and free standing cancer centers. Psgs 340b link is a comprehensive 340b solution with a proven record of delivering bestinclass support through reporting and expertise to assist our clients in optimizing both savings and compliance. Set up perpetual inventory replenishment and split billing to optimize inventory management. That is because dsh, ped and can are subject to the gpo prohibition and mandatory wac use, and that adds a challenging layer of complexity. We are the leading advocate and resource for those hospitals who serve their communities through participation in 340b. Split billing verity solutions verity 340b solutions. Split billing software vendor selection and setup considerations. Klas spoke with 116 340b hospitals to find out how effectively their vendors deliver audit training and guidance as well as splitbilling tools. Helps you to build and maintain a solid 340b network. Order link splitbilling software for 340b covered entities offers superior compliance that is configurable to meet your organizations unique needs. Find 340b tools such as templates for policies and procedures, registration, audit and compliance plans, and additional resources to ensure 340b program integrity.
Because 340b pricing is for medications used in the outpatient setting only, covered entities must have inventory control to ensure 340b drugs are not administered to inpatients. We use 340b split billing software to manage the process of identifying eligible prescriptions. Software splitbilling solutions rulesbased compliance engines what is split billing. Analyzs and oversee the utilization of technological solutions in place for 340b program facilitation e. It is possible to manage a 340b mixeduse program without split billing software. This software can help the entity place orders in appropriate accounts while maintaining auditable records of the accumulations and purchases. Effectively communicate strategy, goals, progress and results to executive management and other matrix partners.
Sunrxs splitbilling solution virtually separates 340b, non340b, and gpo. The health resources and services administration hrsa has recently created a covid19 resources page and is encouraging covered entities to reach out to the 340b. This is for disproportionate share hospitals dsh, pediatric hospitals ped, and cancer hospitals can. Psg offers a highly differentiated suite of solutions enabling you to expertly manage your 340b program. Rxstrategies 340bplus split billing solution provides endtoend 340b program management with a focus on program compliance. The tool can support both mixeduse and retail pharmacy environments. Even with systems that can handle both billing methods, splitclaim billing is a process that doesnt get.
The software automatically determines which prescriptions are 340b qualified, freeing. If you are a cah, sch, or rrc you can read the rest of this for fun since you are not subject to the gpo exclusion. The 340bplus split billing solution takes the complexity out of 340b program. Press releases simplified 340b management and compliance. Although the software can be very effective in helping covered entities manage their programs, it also requires consistent maintenance to ensure integrity. This can lead to the adoption of another software or service often not in communication with other solutions causing inefficiency, higher collection cost, and even a loss of revenue.
Neither gary merchant nor robert theriault have no. Split billing contract pharmacy hospitals community health centers contract pharmacy our contractrx software helps covered entities and contracted pharmacies make the most of. Our 340b link suite of offerings include contract pharmacy administration, split billing software and. He has worked with clients on 340b projects for the past 15 years, planning and directing over 50 340b projects for health systems, acute care and childrens hospitals. American health care is a premier provider of 340b drug programs, disease management and pharmacy benefit management programs to hundreds of hospitals and health centers nationwide. Our team has experience with most splitbilling vendors, wholesalers and billing systems, and we understand the complexities of building and maintaining a 340b program. Verity 340b split billing manages qualified pharmaceutical usage and replenishment in 340b eligible healthcare organizations to optimizing returns on qualified transactions while maintaining compliance. Hospitals deserve a flexible and configurable splitbilling solution uniquely designed to improve workflow and compliance. Verity solutions has installed its auditready, fully compliant 340b solutions in hundreds of facilities. Maxor national pharmacy services disproportionate share hospitals dsh.
We keep a sharp eye on the moving pieces of 340b program management so you dont have to. Outlines the gpo prohibition as it applies to purchasing of medications for hospital mixeduse settings, including the use of wac, gpo, and 340b accounts using a replenishment model to ensure that no purchases of outpatient covered drugs are made through a gpo account. We know split billing is a big part of your program,we can help make sure its also a compliant part. Bkds 340b team has the expertise to provide operational knowledge and recommendations that help covered entities increase savings and maintain compliance. Our contractrx software helps covered entities and contracted. Note from debra demers pssc hrsa presentation on feb 23, 2011 to nepc hospitals. Backed by our sophisticated qualification engine, our split billing and contract pharmacy solutions lead the industry in compliance while maximizing savings. Split billing guidance medicare update for cahs, january 25, 2012 the concept of split billing in both the inpatient and outpatient setting is a hot topic amongst providers as of late, according to debbie mackaman, rhia, chco, regulatory specialist for hcpro, inc. Manual splitbilling solutions software splitbilling solutions rulesbased compliance engines what is split billing. Pharmacy solutions pharmaceutical strategies group. On account of these complexities, many hospitals utilize virtual inventory accumulation andor split billing software to aid in determining whether a particular prescription is eligible for a 340b discount.
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