Unlocking Greater 340 Savings – How to Capture Claims and Savings that Are Often Missed
(April 2024) – The 340B program serves as a lifeline for many communities, allowing them to provide critical services to vulnerable, underserved patients. Unfortunately, the industry faces a spectrum of challenges, from mounting drug manufacturer restrictions to incomplete referral claims capture, hindering a covered entity's ability to optimize its 340B program.
To help covered entities broaden the reach of their 340B program, SUNRx, a leading 340B technology solutions company, recently acquired AuthorityRx, including the automated Advanced Claims Capture solution. By combining the companies' technology and expertise, SUNRx can provide entities with greater resources to serve patients and communities.
Today, when a patient of a 340B entity visits a referral provider, the entity often loses the potential savings associated with their 340B program. In the past, identifying referral claims and other missed claims with traditional referral capture models has been a complex, often manual process, resulting in missing savings.
By uncovering and resolving fallout claims, ACC offers a user-friendly referral claims capture solution that can help significantly increase 340B savings. In fact, in some cases, it can nearly double capture rates and revenue.
Unique in the Industry
- ACC is a third-party administrator agnostic, so you don't need to change your current 340B TPA. It also can be used by TPAs owned by pharmacy chains.
- Even if you are capturing referral prescriptions today, ACC can help your 340B staff qualify for additional claims.
One Solution Can Have a Big Impact
In an industry subject to ever-evolving, complex regulations and restrictions, compliance remains a constant challenge. Some covered entities even limit themselves by forgoing referral capture, leaving 340B dollars behind because of compliance concerns.
The risk of Health Resources and Services Administration audits is ever-present, validating the importance of the claims capture process. ACC streamlines the audit processes while extending eligibility to outside providers with a proven approach that ensures a high level of visibility and transparency.
Security, Transparency and Control
A claims capture solution should be SOC 2-certified, offer a high level of visibility and transparency and track the progress of claims throughout the process.
Streamlined Data Integration
Many entities want to capture additional savings but do not have the resources to go through a lengthy integration. Combining data and analytics from multiple provider databases and diverse platforms can be complex, but it's critical that systems are compatible and can efficiently share data.
ACC eliminates the need for extensive data integration. They do not need EHR access and can work directly with TPAs to streamline the process. Entities also gain useful drug spending metrics and data that can identify and attract new patients and providers.
How They Can Help
We know 340B savings and community programs go hand in hand. For many covered entities, the 340B program is a lifeline, allowing providers to keep their doors open. ACC was created to help covered entities unlock significant savings and give greater resources to serve patients and their communities.
About SUNRx
As a leading health care technology company, SUNRx assists health care facilities with 340B administration. It's technology helps covered entities optimize their supply chain and pharmacy operations with comprehensive, auditable technology-enabled solutions. To learn more about how SUNRx helps covered entities optimize their 340B program, visit www.sunrx.com.
About Aaron Lott
Aaron Lott, PharmD, is the founder and president of AuthorityRx. He built AuthorityRx and designed the ACC solution with his wife, Kim. AuthorityRx has brought millions of new dollars to health care organizations and their underserved communities across the country with an intense focus on pharmacy marketplace dynamics.