Navigation Links
Craneware Showcases Pharmacy Innovation at ASHP Summer Conference
Date:6/3/2013

ATLANTA, June 3, 2013 /PRNewswire/ -- The Centers for Medicare & Medicaid Services (CMS) Recovery Audit Program is targeting hospital billing patterns for outpatient drugs and its audits have called into question millions of dollars in potential overpayments. To help hospitals mitigate the serious pharmacy compliance and revenue risk of overpayments, and to help identify underpayments, Craneware, Inc., the healthcare market leader in automated revenue integrity solutions, which pioneered technology for verifying pharmacy data in 2008; today announced that it will showcase its advanced Pharmacy ChargeLink® innovation at the American Society for Health-System Pharmacists® (ASHP) 2013 Summer Meeting and Exposition to be held June 1-5, 2013 in Minneapolis, Minn.

(Logo: http://photos.prnewswire.com/prnh/20121221/CL33999LOGO )

One of the opportunities emerging from the Affordable Care Act's (ACA) focus on transparency is for healthcare leaders to establish a process for pharmacy revenue integrity and data governance across their hospitals and clinics. Widely used drugs, including Herceptin, Remicade and Lupron, are being targeted by recovery auditors (RACs), with strict consequences if claims are not accurate.

"Craneware solutions help hospitals be prepared to successfully defend their earned revenue in an audit and as part of this process we study the focal points that RACs are targeting," commented Craneware COO Derek Paterson . "More than half of the issues being targeted by recovery auditors are pharmacy related. Key among hospital pharmacy's vulnerabilities are questions about the medical necessity of drugs being dispensed and related documentation, incorrect HCPCS coding, and hospitals billing entire vials when they are deemed multi dose and should be billed as dispensed quantity only. Pharmacy ChargeLink helps identify these potential issues from purchasing data as well as formulary and chargemaster data, and informs on how to bill correctly and avoid the risks of audits."

Underpayments continue to be a significant, largely hidden problem, from HCPCS coding issues to billing units and charge capture issues, it's hard to identify these losses without bringing both data sets together and looking at exceptions.  Typically all that a pharmacy sees is a chargemaster service code, and they do not know what information that service code relates to in the chargemaster.  Craneware is identifying large discrepancies between what pharmacies think is being billed and what is really being submitted for payment.

"One of the tool's most compelling findings was the volume reconciliation variance between our drug spend alongside revenue and usage data," said Kathy Lytal , Parkview Health's director of revenue integrity. "We identified an annual gross revenue variance in excess of $10 million. Pharmacy ChargeLink provided an environment to manage by exception, supporting our ability to clearly identify the individual drugs that were contributing to the variance, and prioritize our process improvement initiatives. Parkview held a Rapid Improvement Event, engaging key clinical stakeholders to identify root causes and develop improved charge capture processes. Identifying the specific sources of the leakage was an incredible value, allowing the team to focus on the process and execute action plans in the responsible areas," Lytal explained.

"Today, healthcare organizations of all sizes must look closely at their pharmacy data and validate its accuracy," said Craneware CEO Keith Neilson . "Many health systems don't realize the sizeable underpayments that occur when they manually manage the numerous points of contact between purchasing, medication-administration, and reimbursement. Data can be lost or degraded anywhere along that path. To enable hospital organizations to efficiently realize the value inherent in the validation of their pharmacy charges, Craneware pioneered an automated solution that supports a proven data governance process for ensuring the accuracy and integrity of pharmacy data."

Technological integration between hospital, clinic and pharmacy solutions has been rare in the past. Most hospitals struggle to link purchase history data to reimbursement activities and continue to use manual methods such as spreadsheets to manage reviews annually, during which time revenue loss is compounded. Craneware's Pharmacy ChargeLink software helps healthcare organizations align their pharmacy data across hospitals and clinics, and solve the complex issues inherent in this reconciliation that are unique to pharmacy. Manual processes represent significant vulnerabilities in charge capture. Having technology to analyze the calculations between purchased billable units and billed units easily pinpoints areas to re-capture compliant revenue. While this seems relatively intuitive, hospital system reporting and analytics between formulary procurement and revenue integrity do not provide transparent integration for audit and review. These challenges require automated solutions in order to mitigate compliance risk and achieve earned reimbursement for one of the most costly supplies in healthcare.

About Craneware
Craneware (AIM: CRW.L) is the leader in automated revenue integrity solutions that improve financial performance for healthcare organizations. Craneware's market-driven, SaaS solutions help hospitals and other healthcare providers more effectively price, charge, code and retain earned revenue for patient care services and supplies. This helps customers optimize reimbursement, increase operational efficiency, minimize compliance risk, and retain more earned revenue. By partnering with Craneware, clients achieve the visibility required to identify, address and prevent revenue leakage. To learn more, visit craneware.com and stoptheleakage.com.


'/>"/>
SOURCE Craneware, Inc.
Copyright©2012 PR Newswire.
All rights reserved

Related medicine technology :

1. EffectiveUI Showcases Patient-Centric User Experience at Forrester Forum
2. CIVCO Showcases "Clearly Different" Products at AAPM 2012 Booth #217
3. Esaote North America Showcases Imaging Solutions for Rheumatology at ACR 2012
4. Teledyne DALSA Showcases Industrys Largest CMOS Dynamic Flat X-Ray Detector at RSNA 2012
5. Samsung Medison Showcases New Medical Equipment and Technology with Samsung Electronics at RSNA 2012
6. Masimo Showcases Advanced, Noninvasive Patient Monitoring Technologies at Arab Health
7. Personna Medical Showcases DermaBlade Line At The American Academy Of Dermatology Annual Meeting
8. Elsevier Showcases Predictive Analytic and Clinical Integration Solutions at HIMSS13
9. Certify Data Systems Showcases Interoperability at Connectathon
10. Study Showcases Effective Approaches for Evaluating the Performance of Executives who Handle Managed Markets Accounts
11. Home Medical Supply Store MedSupplyShop.com Showcases Its Extensive Range of Medical Products
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/8/2016)... , Dec. 8, 2016 Global ... report on the global interventional radiology market analyzes ... The report comprises an elaborate executive summary, including ... various segments and sub-segments. The research is ... research formed the bulk of our research efforts ...
(Date:12/8/2016)... , Dec. 8, 2016  Diplomat Pharmacy, Inc. (NYSE: DPLO) ... a 2016 Top Workplaces National Standard. To ... ... Pharmacy (PRNewsFoto/Diplomat Pharmacy, Inc.) ... on an employee survey administered by WorkplaceDynamics, LLC, a research firm ...
(Date:12/8/2016)... and Markets has announced the addition of the "Endodontic Supplies - Global ... , ... markets for Endodontic Supplies in US$ Thousand. The report provides separate comprehensive analytics ... Europe , Asia-Pacific , Latin ... are provided for the period 2015 through 2022. Also, a six-year historic analysis ...
Breaking Medicine Technology:
(Date:12/8/2016)... ... December 08, 2016 , ... The ... the Undersea and Hyperbaric Medical Society (UHMS), the leading authority in hyperbaric medicine. ... safety. Only a few hospitals and facilities have earned this distinction. This is ...
(Date:12/8/2016)... Islandia, NY (PRWEB) , ... December 08, 2016 ... ... company, is pleased to announce that “Natural Language Processing–Enabled and Conventional Data Capture ... published in JMIR Medical Informatics . , Results of the comparative usability ...
(Date:12/8/2016)... (PRWEB) , ... December 08, 2016 , ... CURE Media ... centers and advocacy groups, has aligned with Upstage Lung Cancer in efforts to combat ... the announcement, Michael J. Hennessy, Jr said, “CURE Media Group is honored to team ...
(Date:12/8/2016)... ... 08, 2016 , ... Premier Fitness Camp (PFC) and The Chopra Center for ... and wellness program, at their world headquarters of Omni La Costa Resort & Spa ... to anyone seeking weight loss, personal development, a healthy lifestyle, or mental and physical ...
(Date:12/8/2016)... ... 2016 , ... Catalent Pharma Solutions, the leading global provider ... products, today announced that it had joined the Pharmaceutical Supply Chain Initiative (PSCI). ... unite pharmaceutical and healthcare companies that share a vision of better, social, environmental ...
Breaking Medicine News(10 mins):