Tag Archives: healthcare reimbursement

INSIDE THIS ISSUE Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information CMS News New, Revised, and Deleted HCPCS® Effective July 1, 2020 CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. Of […]

A few of RJ Health’s subject matter experts held webinar sessions to talk about controlling medical drug spend as well as the different challenges a pharmaceutical organization may run into when launching or updating a drug. Full recordings of the sessions are now available. Choose a session below:

INSIDE THIS ISSUE Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information CMS News CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. Of the 55 AWP Drug Code Price changes this month, 18 (33%) […]

In a review of Medical Pharmaceuticals claims, over 30% submitted with an NDC had an incorrectly mapped HCPCS/CPT® Codes and/or improperly reported NDC units. These errors may lead to miscalculated reimbursement rates, denied claims and a rise in claim appeals / manual intervention. Join RJ’s Product and Clinical teams as they walk through the different […]

INSIDE THIS ISSUE Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information CMS News New HCPCS® Codes Effective April 1, 2020 Now Available Quarterly ASP (Average Sales Price) File Released Hospital OPPS (Outpatient Prospective Payment System) Update April 2020 NOC (Not Otherwise Classified) Pricing File Released CODE UPDATES Large Price Changes: We identify […]

INSIDE THIS ISSUE Clinical News Retroactive Pricing Issued for Q2043 Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information CMS News CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. Of the 52 AWP […]

RJ Health’s Chris Webb and Jason young walk through the different categories of specialty drug prices, and what is required for reimbursement with each. These webinar clips from “Shedding Light on Medically Covered Specialty Drug Pricing Methods” touch upon AWP (Average Wholesale Price), WAC (Wholesale Acquisition Cost), ASP (Average Sales Price), and how they are […]

INSIDE THIS ISSUE Clinical News Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. Of the 224 AWP Drug Code Price changes this month, […]

Join RJ’s Product and Clinical teams as they walk through the multitude of different combinations of drug claims and pricing methodologies, via clips from the webinar “Shedding Light on Medically Covered Specialty Drug Pricing Methods.” In the following clip, Chris Webb explains the main difference between HCPCS and NDC code level reimbursement. All past RJ […]

INSIDE THIS ISSUE CMS News REMINDER – New HCPCS® Codes are Now Effective Quarterly ASP (Average Sales Price) Pricing File Revised for January 2020 Hospital OPPS (Outpatient Prospective Payment System) Update January 2020 NOC (Not Otherwise Classified) Pricing File Drug Reimbursement Code Price Updates 39 Drug Codes required a recalculation of their AWP Code Price Drugs/Devices […]