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Audit Advantage

Audit Advantage is a solution suite of available to Rx Claim Advisor customers, designed to help pharmacies reduce the risk of state, federal and commercial audits. It includes two components—a prescriber eligibility alert and a primary coverage alert—that enable pharmacies to automatically perform these checks at the point-of-sale from within standard workflows and existing pharmacy management systems. Real-time analytics can be viewed based on data available for up to 90 days. Comprehensive reports identify all claims that are denied and includes the reason each claim was denied.

Avoid audit-related penalties and improve efficiency.
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REDUCE RISK OF AUDITS

Access the most current federal and state prescriber data to allow each submitted pharmacy claim to be checked for licensure, status, sanction, DEA prescriptive authority, and other issues. Rejected claims return compliance notifications with clear messaging on the reason for rejection.

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IDENTIFY INELIGIBLE PRESCRIBERS

The prescriber eligibility alert can help pharmacies mitigate the audit risks and financial penalties associated with submitting prescriptions written by prescribers who do not have prescribing authority. Administrative costs can also be reduced by decreasing the time personnel spend researching prescribers and plans.

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CHECK MEDICAID CLAIMS FOR OTHER COVERAGE

Check patient information from each primary pharmacy claim submitted to Medicaid to determine if other coverage exists.