PRESCRIPTION BILLING & ADJUDICATION

How it works…

ClaimPay’s PSAO (Pharmacy Services Administration Organization) provides effective solutions to assist pharmacy, and physician owners, in managing the business administration and financial components related to commercial pharmacy claim adjudication.

ClaimPay’s PSAO is a highly respected Pharmacy Services Administration Organization (PSAO). More than half of America’s independent pharmacies hire a Pharmacy Service Administration Organization (PSAO) to centralize, streamline and oversee certain administrative functions including PBM contract management and negotiations, accounts receivable collections, and cash management reporting.

Do you get denied claims, underpayments, missed deadlines and inaccurate coding? Do you feel this happens to you? Do you often see that you don’t have the time and expertise to manage appeals and other billing issues? Allow our team to help!

Claimpay combines smart technology with healthcare billing expertise to seamlessly manage your practice’s entire revenue process – from eligibility checking, to over 20 million claim edits achieving 98% clean claim rates, to appealing denied claims, to money in your bank account!

Claimpay helps your practice receive all the income you’ve earned, ensuring you’re paid promptly and fully. Best of all, our fees are aligned with your collections – so you get paid before we get paid.

With an average of 20 years of experience, Claimpay works with practices to drive efficiency improvements in all aspects of the revenue cycle. We conduct monthly customer meetings to review performance, discuss trends we’re seeing across practices in their specialty, share knowledge and best practices. Much more than just a billing service, Claimpay is a comprehensive solution that manages the entire revenue process, to help you get paid quickly and at higher percentages than ever before.

Things Claimpay can improve for your practice:

  • Improved collections – on average, practices gain 7-9%

  • Fewer denials – we work them instead of sending them back to you

  • Faster payments – days in A/R is 13 days less than MGMA averages for all specialties, frequently under 30 days – a documented 30% improvement over published MGMA survey data

  • Increased revenue – up to 29% – as a result of pursuing denied or underpaid claims

  • 98% average clean claim rate

  • 20+ million claim edits rules engine

  • U.S.-based workforce