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Business Analytics

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Healthcare markets, regulatory and compliance controls, shifts in consumer behavior, complex product distribution chains, and sophisticated, dynamic services are accelerating the rate of change in business environments. To remain competitive, organizations are challenged to rapidly identify revenue opportunities and threats, and execute swifter actions to increase or protect this revenue. For example: Pharmacies that process over 1-5 million transactions a month have no possible way to review every claim for errors, margin improvement, reimbursement contract management compliance, and denial management. Through the live analytical program 100% of claims and fields in the adjudication can be reviewed for errors and opportunity for improvement.
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ReAssureRx (PBA)

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Veridikal offers Pharmacy Benefit Administration (PBA) services to our clients that have a need to adjudicate or administer claims without using an outside PBM. These services are used for 340b claims processing for Covered Entities and their contract pharmacies; Audit Protocols for validating reimbursement contracts; Part A Facility Billing for LTC, SNF, ALF; Correctional Facilities Direct Billing; and Charity and Cash BINs.
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Rx History

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This data is critical for certain functions within a hospital and clinic setting. The two most important include: 1) Medication Reconciliation upon admission to the acute care or clinic and 2) when a patient is being discharged, the ePrescribing system can utilize this data to ensure there are no therapeutic duplications, improved medication compliance, less controlled substance abuse, and fewer adverse drug events from drug-drug interactions. All these clinical checks have been moved from the retail pharmacy directly into the provider’s screen as they ePrescribe the discharge Rx. The improvements to these functions from implementation of Retail Prescription History Solution will improve global clinical care as well as reduce overall readmission rates.
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340b Auditing

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340b Audit and Network Services provide qualified facilities and assists others in becoming qualified. Veridikal validates the 340b in-network physicians, foot-print, and patient capture rates, with the appropriate compliant contract pharmacy strategy. Veridikal 340b margin optimization program validates the 340b price being paid and provides end-to-end validation of margin.
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