Fee Scheduler

Simplify Your Drug Fee Schedule Workflow

Many payers are challenged by the manual process of managing fee schedules, especially with larger health plans that may have dozens of even hundreds of custom fee schedules.

As an extension of ReimbursementCodes, Fee Scheduler is the first product in the market to provide both a reference database with pricing methodologies in conjunction with a workflow application that enables the build of configurable fee schedules.

Use Fee Scheduler to:

  • Manage fee schedules in accordance to dozens of contracts with providers and pharmacies
  • Establish a central location where fee schedules and derivations can be managed to improve efficiency
  • Reduce the dependency on internal technical resources to manage complex fee schedules
  • Guide fee schedule management with RJ Health data and reference pricing methodologies
  • Create fee schedules by drug type to optimize medical drug spend

Learn More About Fee Scheduler

Enable your team with a single tool to reduce manual efforts

  • Allow your team to select pricing methodologies to reimburse medically covered pharmaceuticals based on contracts
  • Easily backfill rates that are not yet published to apply secondary and tertiary rates

Insurer, Specialty Pharmacy Rely on RJ Health to Price Drugs Correctly

RJ Health examines what happened when one large regional health insurer shifted to billing at the NDC level – and what surprised them when providers attempted to do so.

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Develop fee schedules that align with your contracts

  • Source the industry-leading RJ foundational database and pricing methodologies (AWP, Medicare Allowable, WAC, etc.)
  • Establish custom class pricing for biosimilars and other exception categories

Related Solutions to Support Your Strategy

MMIT offers a variety of reimbursement and coding workflow solutions.