Fee Scheduler Aids in Medical Benefit Drug Reimbursement
MMIT has launched its new Fee Scheduler solution. The product provides a simplified, self-serve workflow for payers to select appropriate pricing methodologies to reimburse medically covered pharmaceuticals. The product will replace payers’ manual processes today across dozens of fee schedules to free up internal resources, streamline the flow of fee schedules to third party vendors and provide clients with the ability to establish custom class pricing to handle biosimilars and other exceptions — all backed by RJ Health data.
Fee Scheduler builds on RJ Health’s familiar ReimbursementCodes workflow application to deliver a first-to-market capability of managing complex drug fee schedules without the need for highly technical resources. The product provides customization options to enable a broader audience of stakeholders to manage fee schedules in accordance with provider, pharmacy and other contracts.
The initial release of this product will include Code level pricing customization/filtering and baseline file production. Subsequent releases will allows NDC level pricing customization and filtering, price selection logic, existing fee schedule uploads and downstream data pushes to MMIT/RJ SaaS applications and data files/APIs for third party applications.
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