CSS analysis pinpoints and resolves claim rejections.
Prior authorization claim rejections are one of the main causes of reduced cash-flow at long term care facilities. Bad debt is created when non-formulary drugs are dispensed but not approved.
CSS consulting pharmacists, using MTMPath™ software, can easily navigate the prior authorization process, since managed care prior authorization forms are built right in to the software. The consulting pharmacist simply selects relevant clinical information to populate the prior authorization form, prints it, and faxes it to the managed care entity.
MTMPath software incorporates a complete medication library that includes the many non-formulary drugs routinely used in the long-term care setting.
The CSS MTMPath software and web-based data storage ensures that:
• Consulting pharmacists have access to pre-existing data infrastructure.
• Nursing administration staff has appropriate and additional resources for timely and appropriate medication dispensing.
• Dispensing pharmacists have the necessary forms in real time to support
clinical rationale for dispensing of non-formulary drugs.