Reconciliation
Validate your Claim Payments Manage account receivables more efficiently. Reconciliation, available exclusively to Third Party Network members, is a highly effective solution for reconciling dispensed prescriptions. H. D. Smith is the only wholesaler to not only reconcile but also chase outstanding underpaid and unpaid claims. Payments are verified electronically to ensure pharmacies are paid according to the agreed amount from adjudication. Designed with busy pharmacies in mind, the Reconciliation online portal shows the current status of a claim and detailed reports, allowing our members to stay informed at the click of a button.
Reconciliation program benefits: •
Dedicated specialist chases partially paid and unpaid claims
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Accessible reports of your outstanding receivables
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Detailed funds disbursement and aging
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User-friendly online portal with real-time updates
“Not only have we collected delinquent insurance payments that we didn’t know were outstanding, but we have also found incorrect insurance reversals that have led to substantial recovery!” - Jim Lehan, Lehan Drugs
Third Party Network 866-429-7747
[email protected]
Implementation Process
Claim Chase Services
Save time, increase accuracy and ensure correct compensation from third party payers. Through a partnership with Net-Rx, we offer an automated, transaction-level reconciliation that verifies your data against electronic remittances and creates a detailed claim adjudication summary. After account paperwork is completed, Net-Rx creates an interface between the software and insurance plans to establish data-sharing capabilities. The end result is a cost-effective, accurate process that provides assurance that funds are being collected, missing checks are tracked and payments are distributed correctly.
Reconciliation not only reconciles, but chases outstanding claims. Our dedicated team researches claim status to determine and aggressively track prescriptions that go unpaid or partially paid. Reconciliation pursues each claim for explanation and status until payment is obtained.
Online Portal
Through a partnership with Net-Rx, we
View status, follow progress and analyze reports via the Reconciliation online portal. Accessible from any location with Internet access, the portal provides both summarily and detailed payment information in real-time. To ensure that members are equipped to utilize these tools to their full capabilities, we provide extensive training during implementation.
offer an automated, transaction-level
Reporting Capabilities
reconciliation that verifies your data against electronic remittances and creates a detailed claim adjudication summary.
Missing Check Locator Manage your reimbursement status more efficiently through our missing check locator program. Use this online tool to view a list of checks that are in transit to your pharmacy. The Pending Remittance report outlines the check information and allows you to trace the checks you never received. Contact Reconciliation with the check information and we will work with the payers to get another
Track payment progress and status through Reconciliation’s extensive reporting capabilities. Reports can be generated by date, insurance plans, location and more. Export the data in either Excel or Adobe for simple data sharing and analysis. Sample reports include: • • • • • •
Payment Summary Outstanding Report Aging Report Total Sales Remittance Lookup Recovery Report
check reissued.
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