Claim Level Reconciliation
Progressive Pharmacies will post your open Accounts receivable Claim level data from you either from your pharmacy software vendor or from your pharmacy switch vendor. Once posted your claims data will be reviewed for validity and completeness. Payment Data Detail will be received and processed and will be matched at the claim level detail including RX number, fill date and other data elements to insure a unique one to one match occurs. This claim level reconciliation is how we can identify underpayments, overpayments, non-compliance to contract terms/rates and provide necessary feedback to the PBM’s to remedy any non-compliance issues. Additionally we utilize payment forecasting tools to know when payments are anticipated and whether or not they are compliant with the PBM’s own contract terms.