- July 16, 2013
-- Pro Pharma Pharmaceutical Consultants, Inc., a pharmaceutical consulting organization which focuses on data analytical expertise, announced today that it has updated and enhanced the JCode Calculator™
Quarter 2013 Update via their secured web access. This is primarily for claims and billing professionals and provides improved efficiencies in resources, time and money. For the last several years Pro Pharma has analyzed the Annual Trend of price changes in the Prescription Drug Industry. The current year’s prices continue to increase for Average Wholesale Price (AWP) and Average Sales Price (ASP). “The Pro Pharma JCode Calculator™ (http://www.propharmaconsultants.com/products/jcode-calculator/) is unique in that all pricing is based on the HCPCS defined unit, so that no calculation need be performed by busy billing and coding professionals”,
states Dr. Craig S. Stern, President of Pro Pharma Pharmaceutical Consultants, Inc. He continues to say “it is as easy as looking up the unit price for any Code, and the calculation is done for you!”
s latest JCode Calculator™
Update incorporates monthly pricing updates for the online Web-Based Software Portal as a quick and accurate reference for busy billing and coding professionals, most specifically in the following areas:
· Durable Medical Equipment (DME)
· Enteral Feeding Products
· Radio-Labeled Codes and Products
Dr. Stern also states that “Billing and Coding Professionals who are spending time on manually looking up codes from multiple sources, assigning appropriate quantities and responsible for medical authorizations, will find Pro Pharma’s JCode Calculator™ to be an invaluable tool to add to their toolkit.”
s JCode Calculator™
provides an invaluable resource to ensure standardization of reimbursement procedures to providers which results in overall savings to the organization due to consistent billing and reimbursement practices. Specifically, there are a few categories which are highly sensitive to the potential of overcharges.“
The JCode Calculator™
is available on a daily, weekly, monthly and quarterly basis and can be purchased on the Pro Pharma Website. Pro Pharma continues to improve our product line by adding new features and client input is invaluable to our mutual success. Unique State Pricing can be added for ongoing clients as requested,”
said Carol Stern, CEO of Pro Pharma. “Call or email to schedule your online Demo.”
Please visit Pro Pharma Consultants website http://propharmaconsultants.com/
for complete information.
About Pro Pharma Pharmaceutical Consultants, Inc.PRO PHARMA
is a multi-service, woman owned, privately held consulting firm offering a vast portfolio of services to public and private entities including self-insured employers, Taft Hartley Trusts and unions, public employers, for-profit hospitals and integrated health networks, health care insurance companies, worker's compensation insurers, small-to-medium sized HMO's, and physician groups.
As a primary service to plan sponsors for achieving below trend results, PRO PHARMA provides an integrated program of administrative process improvements, clinical quality oversight, and provider/member education.
s Consulting services are grounded in the use of data and the communication of that information to define benefit trends, drivers and other analytical indicators. PRO PHARMA markets Biotech Modeling™
, Invoice Screening ™, JCode Calculator™
, Quality Management Program™
, Rx MAC List™, Treatment Calendar™
, and Pro Pharma Suite of Tools™
. The Company directly markets its products in the U.S. and collaborates with partners to reach international markets.
About Quality Management Program™
(QMP)Pro Pharma’s Quality Management Program™ (
QMP) is a multi-faceted approach that targets the pharmacy benefit cost and quality from multiple directions; namely, physician prescribing decisions, member demands, pharmacy oversight and patient education, HR rep education, and messaging to actives/retirees. The program is focused on providing patients and physicians specific tools designed to make more informed purchasing decisions that expand member co-pay dollars. The bottom line is: payers (self-insured, employers, Trusts, etc.) lower their pharmacy trend.
About Invoice Screening™
About 10% of drusg spend is being paid from PBM Invoices, and should have been rejected by clients prior to payment. Pro Pharma’
s Invoice Screening™
analyzes invoices against: formulary compliance, compliance with MAC pricing, eligibility, claims pricing, invalid claims, and excluded benefits, pre-payment as an Accounts Payable function. This ensures that clients only pay for valid claims, which saves time and dollars in the long run.
About Biotech Modeling™
Pro Pharma utilizes both the Medical and Pharmacy paid claims to analyze previous claims experience and to develop a model to project future trends. These issues center on the need for drug specific claims information, processing rules to ensure accurate quantities and maximum payment amounts, and rules for processing miscellaneous claims. The model can be updated with enhancements expeditiously given new Medical and Pharmacy claims experience.
About Treatment Calendar™
s Treatment Calendar™
is a proprietary program comprised of Artificial Intelligence rule sets, which allow for quality and cost comparisons by peer-to peer, peer-to-best in class, peer to national norms, and peer to local norms.Pro Pharma
uses Clinical Protocols to analyze patient encounter data and diagnoses for required exams, tests, and medications. In this way, physician practices can schedule the applicable services for each patient and then review them for exceptions.
functions in the following manner as a:
Quality tool for benchmarking
Tool to align provider and payer incentives by focusing on actionable patient specific quality improvements
Risk management tool to identify therapy that doesn't comply with national norms
Tool to graphically identify gaps in compliance
About Rx MAC List™ (Pharmacy Maximum Allowable Cost™)
The Cost of Drugs is Skyrocketing. Pro Pharma develops and maintains customized MAC Lists for clients to help manage the effects of rapid and high increase of drug prices.
About Pro Pharma Suite of Tools™
s Suite of Tools identifies the cost and clinical issues for both Pharmacy and Medical, and formulates management plans and objectives to develop action plans to address “prescriptions for change”
For more information please visit www.propharmaconsultants.com