The software automatically determines which prescriptions are 340b qualified, freeing. Maintain a separate 340b inventory use a replenishment system splitbilling software. Vendor is responsible for negotiating ceiling prices, network of 340b facilites, and it provides other. Delivers full visibility on both retail and 340b pricing for optimized purchasing. Split billing is the process of separating the inpatient ip and op hospital charges from 340beligible areas. Choosing a 340b splitbilling software solution requires a comprehensive understanding of a facilitys. Ppt comparing apples to apples split billing software. Among the most important members of the 340b team of a covered entity ce are the software vendors. View mike benedicts profile on linkedin, the worlds largest professional community. The importance of compliance compliance best practices. Performs initial compliance audits in conjunction with the 340b financial analyst, maintains program in an auditable state, complete quarterly comprehensive selfaudits and scheduled or ad hoc targeted. To manage a replenishment model, the entity tracks data feeds such as inpatient or outpatient status, patient and prescriber eligibility, clinic location, medicaid status, drug identifier, and quantity dispensed and sends these data into split billing software. The 340b prime vendor program pvp is managed by apexus through a contract awarded by health resources and services administration hrsa. Effectively, this method identifies all of a ces op charge codes and uses them to identify drug.
Aug, 2009 340b split billing replenishment software. Splitbilling software vendor selection and setup considerations. While this option is viable, it requires ample space to accommodate both inventories. These sources include medicare cost reports, annual aha surveys, facility drug purchasing data, and splitbilling software, among others. Discusses 340b inventory models in mixeduse areas of a hospital and the role in compliance of split billing software and multiple purchasing account types. Verity solutions is both a pioneer and a leader in 340b split billing software solutions our robust featureset is flexible to meet and exceed the complex demands of our customers.
By midjune, hatwig said, one manufacturer had notified apexus to cease providing products with orphan designations to hospitals affected by the ruling. Our easytouse splitbilling software works with your pharmacy information system, automatically monitoring all pharmaceutical usage to utilize every contract opportunity. Figure obtained from the 340b prime vendor program. Sep 01, 2015 chris hatwig, ms, fashp of apexus discusses how split billing software helps to keep contract pharmacies organized with respect to 340b requirements. Comparing 340b university and the 340b coalition conference. The apexus advanced 340b operations certificate program goalslearning. The emr or pharmacy billing system data feed to the splitbilling software should include a drug identifier and quantity to record how much of a particular drug is administered to the patient, as well as the.
To the extent a covered entity has a specific concern about 340b eligibility of a new site, the covered entity should contact the 340b prime vendor program 18883402787 or. Userfriendly yet sophisticated, the 340b sm software helps approximately hospitals fulfill their mission to serve indigent patients while facilitating 340b tracking and management. Manual splitbilling solutions software splitbilling solutions rulesbased compliance engines what is split billing. Medicaid mco, medicare opps, private payers identifying 340b claims. In order to support 340b transparency and compliance, prime vendor program staff has researched state medicaid 340b requirements, and provides this as a free tool for stakeholders. Prime has over 15 years experience in building and maintaining 340b solutions and has worked with many tpas building and maintaining contract pharmacy, split billing, discount cards, 340b audit systems and other core functions, enabling tpas to be nimble, competitive and flexible in the 340b space. The 340b program allows covered entities to serve their vulnerable patients by. Split billing software and contract pharmacy youtube. The health resources and services administration hrsa has recently created a covid19 resources page and is encouraging covered entities to reach out to the 340b. Sentry data systems is a healthcare intelligence company, offering software applications to maintain 340b compliance, pharmacy management and contract pharmacy solutions. Audit the eligible provider list within the splitbilling software to ensure that eligibility matches the provider criteria set by the covered entity.
Their primary function involves providing software that, based on the ces data. This entails establishing one centralized, neutral inventory and using a split billing software system to manage it. As a health system, youre doing everything you can to improve the quality of care for patients. Splitbilling software becomes critical in these situations, and this software must be interfaced with the electronic health record system. The advanced 340b operations certificate program is a separate apexus offering that is not a part of the 340b prime vendor program or otherwise associated with the prime vendor agreement between. This software can help the entity place orders in appropriate accounts, which should support 340b compliance while still having only one physical inventory. Discusses 340b inventory models in mixeduse areas of a hospital and the role in compliance of splitbilling software and multiple purchasing account types. Splitbilling decision checklist 340bpvp document repository. Pharm coord 340b admin rev mgt in carbondale, illinois. The emr or pharmacy billing system data feed to the split billing software should include a drug identifier and quantity to record how much of a particular drug is administered to the patient, as well as the patient status, to determine the replenishment account e.
Audit the eligible provider list within the split billing software to ensure that eligibility matches the provider criteria set by the covered entity. For example, instructors outlined the steps in starting up as a ce subject to the gpo prohibition, including how far in advance. For example, instructors outlined the steps in starting up as a ce subject to the gpo prohibition, including how far in advance the ce should begin negotiating contracts with split billing software systems. Split billing contract pharmacy hospitals community health centers contract pharmacy our contractrx software helps covered entities and contracted pharmacies make the most of the 340b program. Establish splitbilling tracking systems for all copayments and rebates.
Softwaresplit billing system companies continue to add solutions yearly and vary strategies for payment companies have agreements with some wholesalers man. Performs initial compliance audits in conjunction with the 340b financial analyst, maintains program in an auditable state, complete quarterly comprehensive selfaudits and scheduled or ad hoc targeted audits of various aspects of sihs 340b program. The combination of our intuitive drug inventory system and splitbilling software ensures that administering the 340b program in a hospital setting remains compliant, is uncomplicated and furnishes improved management of 340b programs. Delivers full visibility on both retail and 340b pricing for. We encourage all 340b hospitals to consider joining our association and look forward to working with our. Split billing contract pharmacy hospitals community health centers contract pharmacy our contractrx software helps covered entities and contracted pharmacies make the most of the 340b. As such, choosing a software vendor that provides robust split billing functionality is critical to establishing an effective program.
Documenting 340b value is key to success pharmacy times. Mike benedict vice president apexus, 340b prime vendor. Pharmaforce is a third party administrator that supports your contract pharmacy, mixed use split billing, and prescription discount cards 340b program management needs. The prime vendor has developed a number of tools to help covered entities operationalize 340b program compliance guidelines. On account of these complexities, many hospitals utilize virtual inventory accumulation andor split billing software to aid in determining whether a particular prescription is eligible for a 340b discount. The advanced 340b operations certificate program is a separate apexus offering that is not a part of the 340b prime vendor program or otherwise associated with the prime vendor agreement between hrsa and apexus the program is provided solely for education andor instructional purposes, and the learner assumes exclusive responsibility for using and applying the information presented therein. Split billing is the process of separating the inpatient ip and op hospital charges from. Mar 26, 2020 as the covid19 pandemic continues to sweep the nation, many 340b stakeholders are curious about the implications for their 340b programs and any flexibility in program requirements that may emerge. New years changes to the 340b discount drug program raise.
Split billing verity solutions verity 340b solutions. These drug inventory and purchasing systems are distinct from hospitals patient billing systems and. Clean data makes it easier for the pharmacy information system to clearly delineate which patients are 340b eligible and. Leading companies providing 340b software, management, forms, pricing, 340b consulting. Split billing contract pharmacy hospitals community.
New years changes to the 340b discount drug program. Because 340b pricing is for medications used in the outpatient setting only, covered entities must have inventory control to ensure 340b drugs are not administered to inpatients. Chris hatwig, ms, fashp of apexus discusses how split billing software helps to keep contract pharmacies organized with respect to 340b requirements. For those facilities that are initiating a 340b program for the first time, it is important to keep in mind the high likelihood of being audited. To manage a replenishment model, the entity tracks data feeds such as inpatient or outpatient status, patient and prescriber eligibility, clinic location. Pharmaforce 340b third party administration solutions. Dec 08, 2017 inventory in one place and non 340b drug inventory in another.
We encourage all 340b hospitals to consider joining our association and look forward to working with our members in 2019 to protect this vital, lifesaving program. As the covid19 pandemic continues to sweep the nation, many 340b stakeholders are curious about the implications for their 340b programs and any flexibility in program requirements that. Splitbilling software separates a purchase order into different accounts using logic based on. Describe the steps that occur to link distributor ordering accounts to the prime vendor. Nov 20, 2017 among the most important members of the 340b team of a covered entity ce are the software vendors. We offer a different approach to the technology, fees, and customer service that is necessary for you to maximize your 340b opportunity. Office of inspector general overview of the 340b drug pricing program the 340b drug discount program 340b prime vendor program. Using splitbilling software to simplify 340b ordering w. Sentry data systems the healthcare intelligence company.
Controlled substance ordering system csos compliance considerations. Pharmaforce is a third party administrator that supports your contract pharmacy, mixed usesplit billing, and prescription discount cards 340b program management needs. New this year, 340b university delved into some of the operational weeds. Hrsa is the federal government branch responsible for administering the 340b drug pricing discount program. Monitor and manage 340b split billing software to ensure appropriate application of. The term split billing is used to describe this software, which splits a purchase order into two or three different accounts. We use 340b split billing software to manage the process of identifying eligible prescriptions. Software split billing system companies continue to add solutions yearly and vary strategies for payment companies have agreements with some wholesalers man hours to perform duties will vary companies have added features for future 340b changes. Psgs splitbilling software is fully hosted on our secure website, allowing full inventory visibility and fast, direct ordering from wholesalers. Comparing apples to apples split billing software overviewinventory management 1 comparing apples to apples split billing software overview inventory management. Why covered entities should capitalize on complete 340b. Prime has over 15 years experience in building and maintaining 340b solutions and has worked with many tpas building and maintaining contract pharmacy, split billing, discount cards, 340b audit. Affairs and the 340b prime vendor program managed by apexus.
Contracted and operated software for 340b split billing and. Review the accuracy of 340b sites listed in the hrsa database for any additions, deletions, and corrections. Our industryleading 340b program management technology supports hundreds of covered entities and contract pharmacies across the u. There are both federal and state 340b specific medicaid requirements for covered entities, and this resource focuses on making state requirements accessible. Set up split billing to manage procurement and inventory replenishment in 340b. Oftentimes, that places additional administrative and compliance challenges on your organization. Our software solutions help you improve financial performance, maximize operational efficiency and maintain regulatory compliance.
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