Industry-first Online Contract Management Technology from Inmar Positions Pharmacies to Ease Eroding Margins and Quantify Savings
Inmar, a leading provider of revenue recovery services, today announced the release of patent pending Contract Management technology. In an environment where margins are increasingly under fire, the web-based tool arms pharmacies with the information necessary to increase profitability.
Contract Management, an enhancement to Inmar's PRISM Spectrum® web tool, goes beyond contract database products currently available. The Contract Management tool is the first system that electronically matches individual claims directly to carrier contracts using a 10-step proprietary process to validate that the paid amount meets contract terms. Users also can view extensive information regarding contract profitability on screen and benchmark carriers on key metrics. The tool is used for profitability and compliance monitoring on a number of levels for both generic and brand drugs.
"Industry trends such as the AWP rollback make it increasingly difficult for pharmacies to maintain profitability," says Jennifer Mauldin, president, Inmar Revenue Recovery. "Aggressive contract management is critical to protecting already squeezed margins."
Identifies underperforming contracts and ensures accurate claims reimbursement
Inmar's Contract Management tool automates highly complex labor intensive processes and provides pharmacies with the information needed to ensure that they are being paid at the contracted rate and that they identify underperforming contracts. Pharmacies can then use the tool to produce in depth reports to work with carriers for better reimbursement rates. Mauldin adds that, "The reports will be helpful to both parties during negotiation because they can look at real numbers—there is no subjectivity. It takes just seconds rather than days to generate reports from the web-based workflow tools."
Completes complex calculations in seconds for brand and generic drugs
Contract Management functionality also considers the important differences between the claims processes for generic and brand drugs. Carriers reimburse pharmacies for generic drugs based on what they determine to be the Maximum Allowable Cost (MAC). It is problematic for pharmacies that the MAC rate at which they are reimbursed can fall below the acquisition cost. Inmar's technology automatically collects information from many industry and government sources and compares it to the per-prescription and per-pill (unit) gross profit requirements defined by the pharmacy.
For brand drugs, Contract Management matches each claim against the specific rate agreed to in the contract between the carrier and the pharmacy. A workflow tool allows users to decide what reimbursement is unacceptable and to view summarized data on a number of different levels for both generic and brand drugs.
Quantifiable ROI drawing a strong response from pharmacies
Few pharmacies have the resources to devote to the extensive analysis made possible through this tool, which explains the strong industry response to Inmar's Contract Management capabilities, according to Mauldin. "One pharmacy client involved in product testing expects that the MAC (Maximum Allowable Cost) exception processing capabilities alone will enable the company to double its savings over last year and will save hundreds of hours of analysts' time," says Mauldin.
Six large pharmacy chains and one independent pharmacy consolidator have already contracted to implement the tool in the next few months.
Inmar has released five major web-based technology tools for pharmaceutical and consumer goods companies over the past two years. To learn more about all of Inmar's solutions for pharmaceutical and consumer goods retailers and manufacturers, visit www.inmar.com