Tag Archives: compliance

$35 billion of drug-related revenue comes from healthcare provider offices. Health plans have established policies that require additional information, not just the HCPCS code. This additional information enables payors to differentiate between drugs that exist under the same billing codes. Recent claims analysis revealed a high degree of confusion from providers on what is required […]

Our latest white paper demonstrates the value and versatility of an automated medical drug claim edits solution. RJ Health’s system implements a rules-driven platform to reduce overall medical drug claims errors and improve overall efficiency. Appropriate reimbursement for drugs covered by the medical benefit increasingly requires more data and structure. Many of the billing systems […]