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The 340B program serves as a lifeline for many communities, allowing them to provide critical services to vulnerable, underserved patients. But unfortunately, the industry faces a spectrum of challenges, from mounting drug manufacturer restrictions to incomplete referral claims capture, which hinder a covered entity’s ability to optimize their 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 (ACC) solution. By combining the technology and expertise of the companies, SUNRx is able to provide entities 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 that results 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.
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 HRSA audits is ever-present and ensuring that your claims capture process is audit-ready is critical. 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. We do not need EHR access and can work directly with TPAs to streamline the process. Entities also gain useful drug spend metrics and data that can identify and attract new patients and providers.
Unique in the industry
ACC is Third-Party Administrator (TPA)-agnostic — there’s no requirement to change your current 340B TPA. It can also 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.
How we can help
We know 340B savings and community programs go hand-in-hand. For many covered entities, the 340B program is a lifeline that allows them to keep their doors open. We created ACC to help covered entities unlock significant savings and give them greater resources to serve patients and their communities.
Aaron Lott is the founder and president of AuthorityRx. He can be reached at alott@authorityrx.com.
