Category: Sponsored Content

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Running a 340B pharmacy is a complicated business, especially considering the varying requirements from payers that can wreak havoc on your bottom line. That’s why Sentry continually works to develop new tools and services to help you stay on top of things and keep your reimbursements moving.

Claims Manager Plus (CMP) is our solution; an automated software solution that helps users adhere to payer requirements, minimize denials, and speed up processing pharmacy claims by almost any payer, or for carving in or out 340B. It’s also indispensable in helping manage complex, government-mandated reporting requirements.

Claims Manager Plus helps you correct errors on claims and adhere to other requirements by flagging items such as:

• Missing modifiers and prices
• Purchase validation of NDCs billed
• Unspecified destination payer codes
• Incorrect NDC codes
• Drug quantity and unit of measure validation
• NDCs not matched to HCPCS codes
• Crossover modifiers between payers

The tool automatically modifies claims based on the configurations you establish. It flags errors and rejections and can

Eighteen 340B Covered Entities to Receive Grant Funding to Help Further Their Missions in the Communities They Serve

Capture Cares is pleased to provide grantees once again with the funding that they need to enable their missions. The projects and programs that these Covered Entities wished to receive grants for are honorable and empower the community, as well as the entity to provide additional services. The 2021 Grantees announcement was made during the 340B Summer Conference on July 27.

Capture Cares is an organization created to help fund the personal or organizational missions of 340B safety net providers and their patients in need. Since its inception in 2019, the Foundation has granted more than $900,000 in funding. Capture Cares was created by Chris Hotchkiss, President of Capture Cares and Co-Founder of CaptureRx, in order to further the missions of providers that focus their efforts on helping those that are underinsured or uninsured.

2021 Capture Cares Grantees:

Community Mission Grants

An organization’s unique mission

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An HIV diagnosis does not have the same meaning today as when the virus first emerged in the 1980s. People living with HIV can now expect to live a long, full life, as long as they adhere to a prescribed antiretroviral treatment regimen. AIDS Healthcare Foundation (AHF), the largest provider of HIV/AIDS medical care globally, plays a key role in ensuring that people living with HIV can adhere to treatment and stay healthy.

The Role of Adherence in HIV Treatment

In HIV care, adherence is everything.  Staying on one’s HIV medications lowers the amount of HIV present in the blood.  That means the person living with HIV is healthy and can live a full, normal life.  If the level of virus becomes low enough to be undetectable – which it can if the person takes their medications religiously, without fail — the virus can’t be transmitted.  That, in turn, breaks the chain

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Since its introduction in 1992, the 340B Program has vastly altered the pharmacy landscape. In these very uncertain times, as we continue to grasp COVID-19’s longevity and struggle to predict a tumultuous 340B environment, we see considerable talk about 340B optimization. From expanding contract pharmacy networks to engaging specialty pharmacy strategies to the latest “hot button” around improving 340B referral capture, the 340B Program’s benefits are firmly on everyone’s radar. 

Here are a few guiding principles for a compliance-first approach as covered entities consider 340B expansion and optimization.

1. Keeping Your Eyes on the Prize

As consultants, we work with many provider types who have varying methods of 340B management. Some covered entities lean on a multi-disciplinary, interdepartmental committee approach whereas others utilize a smaller, dedicated team of 340B specialists to maintain compliance and pursue targeted avenues for 340B growth. Unfortunately, occasionally we also run into providers that have inadvertently lost sight of 340B’s value

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Finance guys like myself often have the reputation of being unwilling to spend money. However, we can always be convinced to invest in activities with a high likelihood of return.

The financial pressures of the last year have underscored the importance of the 340B program and its impact on hospital finances. Against the backdrop of cost-cutting measures across the organization, it may seem counterintuitive to ask for an investment in more staff to run your 340B program. Yet, based on our experience with covered entities that have a dedicated 340B program manager, versus those that don’t, we believe it’s possible to justify the cost in a way that will resonate with your senior finance leaders. (Spoiler alert: an ROI of 150 times an employee’s salary makes a pretty convincing argument!)

There are several advantages to a program manager focused on optimizing the performance of your 340B program. In our new e-book, we look at five tangible ways your program benefits from a dedicated 340B