SCRIPTPRO 340B SOLUTIONS SHAFI SHILAD, VP BUSINESS DEVELOPMENT SSHILAD@SCRIPTPRO.COM 913.948.2068 A Comprehensive Approach 340B Operational Challenges Eligibility o Is the patient eligible? o Is the script prescribed from an eligible provider? o Is the claim eligible (dependent upon primary plan being billed). Inventory Management o Is the process manual or automated o Labor intensive Cost factor o Human Errors Wrong inventory selected o Drug Diversion Contract Pharmacy Relationship o Contract terms Fixed Fee/ Variable Fee Profit Sharing Risk Mitigation Plan Audit Process Reconciliation Process A Comprehensive/ Seamless Approach Dispensing System Manages Inventory/Eligibility/In-Store Process 1
ScriptPro 340B Solution Determines eligibility, chooses best-value stock, and ensures insurance is billed correctly for patients, prescribers, and encounters. This is maintained dynamically by the system, in real-time, to ensure Adjusts between inventory centers, as needed, and generates automatically based on pharmacy preference Automatically cleans up scripts where conditions have changed, switching inventory center and rebilling as needed for auditing purposes ScriptPro 340B Solution Patient have eligible encounter? Patient encounter interface Check patient eligibility file Patient default comments Eligible Scripts- ICD-10 Prescriber associated with Covered Entity? Prescriber Interface/ List Import Referral Information Patient default comments Audit Trails 2
Summary Dispensing System Manages Inventory/Eligibility ScriptPro Third Party Management System The most comprehensive Third Party Management System in the market. Accounting Management Financial Reporting (Dashboard with backup) Risk Assessment of the program Contract Management System Payer Audit Management Internal Audit Management Management Reporting Analytical / Forecasting / Ad hoc Reporting 340B Management/ Reconciliation ScriptPro Third Party Management System DEPTH OF SERVICE Liability Recouped 3
Accounting Management Accounts Receivable is the critical step that turns accounting money into real cash. Aging receivable can result in interest payable instead of interest receivable since you will have to borrow to pay for growth. Manage A/R and all its metrics at transaction level Criteria for Success Pharmacy Department Strategic Decision Sales/RX/GM$ Carrier/Plan Medicaid/Medicare 340B/LTC Opportunities Sales/RX/GM$ Write-offs/Adjustments Carrier/Plan/Store Week/Month/Year Managed Care Department Contract Repository Expected vs. Actual Payments Under/Over Payments Timely Payments Transaction Fees Audit Management Adjudication Charges Payment Turnaround MAC Reports Multiple MACs Accounting Department A/R Balance Adjustments Write-offs/Reserves Transaction Fees Cash Disposition Liability Management Recoups Auditable By Carrier/Plan Store/District Week/Month/Year Cost Objectives--ALL 100% automated billings Automated Payment Processing Automated financial Reports Direct Bank Feeds Work Flow Management Internal Performance Control T R A N S P A R E N C Y Key Business Indicators 340B MANAGEMENT Create 340B Covered Entity profile. Establish fee structure Establish weekly, bi-weekly or monthly Covered Entity/ Pharmacy settlement schedule. Automatic G/L receivable, payable entries created. Detail Covered Entity billing reports automatically Transfer In/Out of 340B facilitated. 4
A Comprehensive/ Seamless Approach Dispensing System Manages Inventory/Eligibility/In-Store Process Thank you 5