Sentry Data Systems, Inc., a leader in pharmacy procurement and utilization management, 340B compliance and advanced healthcare analytics solutions, today announced the addition of Claims Manager Plus, an innovative new solution that helps hospitals adhere to payer reporting requirements — minimizing payer denials and accelerating payment for 340B covered entities’ Medicaid pharmacy claims.
Claims Manager Plus ingests a hospital’s daily claims file and runs it through a sophisticated rules engine to modify claims based on the hospital’s defined configurations, as well as parse out claims not meeting criteria for payment. These flagged records can be adjusted and then immediately revalidated for accuracy on a real-time basis directly within the application. The clean claims are subsequently exported and sent back to the hospital for submission to the payer.
Further, as modifications are made to the claims, new configurations are incorporated into the rules engine so future claims will be automatically adjusted, eliminating the need for manual intervention. This process results in significant claims adjudication efficiencies for Medicaid and other applicable payers while reducing the percentage of rejected claims over time.
“Sentry’s long-term success in the healthcare industry is predicated on a philosophy of continuous innovation to lead the market in value-based solutions that best serve our customers,” says Travis Leonardi, CEO and founder of Sentry Data Systems. “We’re acutely aware of the impact resulting from delayed or denied claims on an organization’s revenue cycle, and Claims Manager Plus dramatically helps expedite time to reimbursement.”
The new solution offers a rapid implementation and works for all hospitals looking to modify pharmacy claim information, regardless of whether they participate in the 340B program. However, for those that do, Claims Manager Plus functions independently and is not tied to Sentry’s 340B solution suite.
“Customer feedback has been invaluable to Sentry to deliver better solutions,” says Jami Hernandez, Product Manager at Sentry Data Systems. “With a focus on streamlining the process and improving efficiency directly within the software, Claims Manager Plus offers significant advantages by reducing denied claims and days in accounts receivable. It’s exciting to see the dramatic improvements in the claims adjudication process and the productivity of billing departments for the hospitals using this solution.”
Please visit the Claims Manager Plus page on the Sentry website to learn more.
About Sentry Data Systems, Inc.
Sentry Data Systems, Inc. is a pioneer in providing technology solutions that help healthcare providers address their three biggest challenges: reducing total cost of care, managing compliance and producing better quality. Thousands of hospitals and care locations across the country rely on Sentry’s integrated platform for their solutions, which provide decision support for millions of unique patients and have helped hospital systems and IDNs realize billions of dollars in documented savings.
This post is related to:340B