Pharmacy claims adjudication is complex due to the intricate interplay of drug formularies, patient eligibility, and varying insurance plans. Reimbursement is constantly changing due to evolving healthcare regulations and drug pricing structures.
Veridikal’s pre- and post-edit (PPE) solution, DetectRx, stands as the premier choice for optimizing reimbursement, enhancing productivity, expediting collections, minimizing resubmissions, and boosting profits.
In contrast to legacy PPE systems with 5-10 basic rules, Veridikal’s next-generation platform features hundreds of advanced, customizable business rules and edits tailored to meet the unique needs of each customer.
DetectRx changes the way that both individual pharmacy locations and national chains use their data to drive margin improvement, mitigate audit risk, and provide actionable insights.
Leveraging event processing technology, DetectRx operates through a sophisticated business analytic platform, complete with an integrated dashboard. This live analytical technology captures 100% of claims and fields during the adjudication process, identifying errors and pinpointing opportunities for improvement.
Veridikal Technologies is a company focused on providing business analytic solutions for pharmacy and hospital business sectors. Our aim is to simplify the complexities of pharmacy data management. Veridikal offers Pre and Post Edits (PPE), Pharmacy Benefit Administration (PBA), and Medication Reconciliation solution sets designed to meet the unique needs of various classes of trade including hospitals and medical centers, university health systems, long-term care pharmacies, retail pharmacies, specialty pharmacies, hospices, correctional facilities, and employers/self-insured plans. Veridikal's advanced and informative pharmacy solutions are trusted and relied upon by all pharmacy classes of trade, pharmacy wholesalers, PSAO's, GPO's, industry advocacy, and regulatory groups.
Marti Jones brings more than 20 years of integrated communications experience from world-renowned organizations. Marti’s career has grown from raising awareness and funds for the American Red Cross before and after 9/11 to leading strategy for brands such as Mayo Clinic, Duke Health, and M Health Fairview, which included communications for change management and COVID-19. Marti's messaging portfolios are supported by her academic background and proven methodology, as she taught writing at the University of Minnesota and honed her craft at UnitedHealth, UCare, and RXinsider, Revel Health and Hill and Knowlton. Marti received her master’s degree in public affairs and administration from George Washington University and Bachelor of Arts degrees in communications and psychology from Augustana University.
This post is related to:
Finance: Worker's Comp, Claims, PA Management, Adjudication
