Pharmacies continue to struggle under the weight of drug prices and an inequitable
reimbursement scale. To ease the burden on the pharmacies, Satori Solutions Inc developed the Pharmacy Reimbursement Management tool (PReM), in a collaborative effort with Amruta, Inc., an Explainable AI and Data Science IT platform and services company.
PReM has a browser interface and can be hosted via the cloud or loaded on a local machine, and it has multiple modules (software applications). The first application, ChargeReviewer, is just released!
ChargeReviewer allows pharmacies to track payments for specific drugs which are paid based on “the lower of charges” or some other payment rate such as MAC or AWP - X%. This analysis allows the pharmacy to determine if charges need to be adjusted to maximize reimbursement while also being in line with current market rates.
By trending various factors, such as AWP rates across payers or NDC codes for the same drug, pharmacies may identify these opportunities as well as create customized comparisons of reimbursement rates for specific drugs from multiple payers. In addition, an analysis of reimbursement from payers will assist in ensuring that reimbursement is made in accordance with rate tables and calculation methodologies cited in the payer’s agreement.