Covered entities work closely with 340B administrators such as SUNRx to manage and optimize their 340B program all while helping the client ensure compliance with federal regulations.
As a compliance-focused 340B administrator, SUNRx helps covered entities optimize their 340B program so they can expand access to affordable medications and healthcare services for low-income and uninsured patients. SUNRx delivers a hands-on approach, and provides industry-leading program design, implementation, regulatory expertise, and unparalleled customer support.
SUNRx A complete and integrated program to support you needs with Split Billing, Contract Pharmacy a real-time Cash program for your uninsured patients allowing you to adjudicate cash prescription claims so you can pass along savings to low-income and uninsured patients. The SUNRx program also includes a robust claim capture for referral prescriptions, purchase order optimization to minimize WAC expenditures and a robust reports menu.
SUNRx provides comprehensive, auditable technology solutions and high-touch customer service with a hands-on approach to program implementation, split-billing contract pharmacy setup and ongoing program management. We offer:
- Customer Service Experience
SUNRx has extensive experience implementing and managing 340B programs since 2006 and provides industry-leading audit support as evidenced by our positive audit findings. Clients and state hospital associations recognize our account teams as the most knowledgeable and customer-focused in the industry. SUNRx also offers integrated pharmacy benefit management (PBM) through its parent company, MedImpact Healthcare Systems, Inc., an independent, trend-focused PBM.
- Commitment to Compliance
SUNRx helps covered entities: maintain accurate and current 340B database information; recertify eligibility annually; prevent diversion to ineligible patients; prevent duplicate discounts; and prepare for program audits.
SUNRx technology integrates low-cost solutions, real-time processing, some of the most advanced compliance protocols and a cash program that allows entities to pass program savings on to their low-income and uninsured patients.
SUNRx’s 340B program can be implemented with any electronic medical record system, wholesaler, switch vendor or pharmacy to serve their patients for maximum flexibility and the greatest financial benefits.
iVantage Health Analytics
Benchmarking, Performance Management
iVantage Health Analytics provides hospitals and healthcare systems with performance management analytic tools for benchmarking, strategic planning and payment optimization.
iVantage's unique approach, which combines sophisticated tools with hands-on expert guidance, is engineered to create actionable and measurable performance improvement for our clients.
Some of the nation’s largest health systems, regional providers and community hospitals rely on our cloud-based reporting and analytics to help identify and prioritize opportunities for market, clinical, financial and operational improvement.
Benchmarking & Performance Management
The iVantage benchmarking and performance management tool enables hospitals and health systems to identify and prioritize opportunities for operational clinical quality and cost management improvement. With exceptional accuracy and detail, iVantage Performance Manager™ analyzes performance over time and compares to affiliates, industry peers and self-selected cohorts.
Physician Office Performance Management
iVantage's physician office performance management tool helps hospitals identify variance and prioritize opportunities for cost reduction at their physician practices.
Market Planning and Strategy
iVantage's strategic market planning tool, iVantage Market Intelligence™, offers hospital strategists, planners and merger and acquisition teams access to current, actionable market intelligence.
iVantage's reimbursement analytics tool, iVantage Reimbursement Analyzer™, aggregates all payor, patient and payment data into a single application to optimize managed care contract revenue.
The Chartis Center for Rural Health
The Chartis Center for Rural Health brings an unmatched capability to assess the performance of rural healthcare assets with their deep consulting and rural-relevant analytic experience. The CCRH builds upon the well-established iVantage history of experience providing thought leadership to rural health leaders. This rural-relevant expertise and a proprietary database of operational indicators is critical in the assessment of the efficiency and effectiveness of rural assets when comparing like facilities across the nation.
The Chartis Center for Rural Health offers the industry leading rural-relevant services to provide:
Rural-relevant insights into the performance of rural providers
- Comparisons of health system “rural sisters” to each other and to other systems that have made similar investments in the partnership and acquisition of rural providers.
- Technical and advisory assistance to mine analytics to identify strategic and operational opportunities and develop interventions to “move the needle” and improve position and performance.
- Perspective and appreciation of the rural health safety-net function and an understanding of the health disparities in the communities they serve.
Accounts Payable, AP Card Payment Program
CommercePayments™ combines the latest in accounts payable technology and payment disbursement to offer innovative solutions that streamline accounts payable processes and create revenue for AP departments without changing current banking relationships.
Capitalize on process efficiencies and generate monthly revenue share earnings by activating a CommercePayments™ AP Card payment program, utilizing the Visa® Network. This flexible solution requires no software to host and the Commerce Bank Vendor Enrollment team will actively contact and enroll vendors on your behalf to maximize your earnings. CommercePayments™ AP Automation modernizes invoice receipt and capture, approval workflow, and payment by utilizing a single payment file. Enhance process efficiencies and gain real-time visibility to your AP information, enabling your staff to spend time on strategic tasks such as spend analysis, discount capture, and optimizing working capital overall.
CommercePayments® delivers innovative accounts payable products and services that automate invoice processing, workflow and payments. Combining the latest in technology with high-touch service, CommercePayments tailored solutions eliminate manual, paper-based tasks; reduce expenses; create efficiencies; and provide an opportunity to earn revenue.
Supply Chain & Operational Solutions
As a trusted supply chain partner with over 20 years of health care experience, Vizient connects hospitals to a robust and reliable network of suppliers, distributors and service providers.
Vizient is the largest member-driven, health care performance improvement company in the nation. With more than 2,200 supplier and distributor agreements and $100+ billion in purchasing volume, our sourcing and contracting portfolio represents nearly 90 percent of the products and services our members purchase.
Vizient’s pharmacy program offers more than 12,000 products and services and $50 billion in annual purchasing volume. Differentiated clinical support tools and supply chain analytics dashboards maximize pharmacy performance. Plus, Vizient manages drug supply stability amidst shortages and drug pipeline volatility. No other GPO has taken such bold measures to address this critical problem.
Vizient is much more than just a supply chain solution. Not only are we focused on lowering supply costs and driving operational efficiencies, Vizient’s performance improvement platforms are designed to reduce unnecessary clinical and operational variation, improve clinical outcomes, and execute strategies for market success. Our unmatched access to organizational databases, our robust analytics capabilities and a roster of expert health care consultants help our members achieve more than they can alone.
Vizient’s capabilities enable us to deliver a new level of insight unrivaled in the industry. We exist to make our members successful, connecting them to solutions that boost quality and improve business to help deliver exceptional, cost-effective care.
Class Action Capital
Class Action Settlement Claims Management
Class Action Capital is a market leader in class action settlement claim management. They work on behalf of over 5,000 corporate clients, including a large number hospitals, healthcare facilities and state hospital associations, helping to recover refunds on their behalf from recent class action settlements.
Class Action Capital help their clients monitor and identify settlements in which they are eligible and perform the necessary work to recover their share. Many hospitals do not have the time, resources or relevant data available to file a settlement claim, and Class Action Capital will work with them to submit a fully comprehensive claim recovery, while minimizing the use of their employees’ time, internal resources and the risk of errors when managing claims themselves. Class Action Capital works on a contingency fee basis, so there is no up-front cost, risk or hidden fees.
The Remi Group
Equipment Maintenance Management Program
Remi's Equipment Maintenance Management Program replaces multiple service agreements and extended warranties with one agreement that costs less and is more flexible than the Original Equipment Manufacturer (OEM) or Independent Service Organization agreement. Remi does not maintain or repair equipment but provides a single point of contact for managing service events and is service vendor neutral. The Remi solution delivers coverage that includes the costs associated with parts, labor, travel, emergency repair and preventative maintenance.
- Cost Reduction: Save 15 - 22% off your current service agreement pricing with the quality and coverage of your existing service.
- Vendor Neutrality: Provides an unbiased vendor solution that delivers timely and qualified service in accordance with OEM specifications.
- Consolidation: Manages the maintenance of multiple equipment types under one fixed-price agreement with the flexibility to customize equipment coverage.
- Administrative Efficiency: Reduces the time you spend administering multiple serivce agreements from various equipment manufacturers and service providers.
Remi offers an extraordinary level of industry experience and technical expertise that few can rival. Its goal is to enhance performance, improve vendor responsiveness and eliminate the distractions related to managing your equipment portfolio. But most importantly, Remi strives to extend the useful life of your electronic equipment and dramatically reduce equipment maintenance management and repair expenses.
Provider Enrollment Services
Hospital Services Corporation, formed in 1985, is a wholly owned for-profit subsidiary of the New Mexico Hospital Association. The Provider Enrollment Service encompasses initial health plan enrollment, CAQH initial set up and ongoing maintenance, and recredentialling and maintenance of enrollment services. The goal is to accurately and efficiently enroll providers with Medicare, Medicaid and commercial payers in order to accelerate cycle times for hospital billing and reimbursement.
Third-Party Liability & Workers' Compensatioin Claim Recovery Services
Terry J. Garrett & Associates, P.C. d/b/a TGA Solutions (“TGA”) has successfully served healthcare providers for more than a decade. TGA has consistently increased revenue deriving from both Third-Party Liability and Workers’ Compensation Claims.
TGA has a dedicated multi-disciplinary team of professionals (Claim Specialists, Attorneys, Case Managers and Nurses) aggressively and successfully processing Third-Party Liability and Workers’ Compensation accounts using a patient centric approach to help facilitate a timely and maximum reimbursement. All TGA associates are continually trained on procedures and processes developed to speed payment of claims. This while ensuring an emphasis on treating every patient that may be contracted with the highest degree of respect and care.
TGA requires NO UP-FRONT PAYMENT. All costs are paid by TGA with NO payment required until claims are paid and posted to accounts. Services are tailored for each hospital, TGA does not utilize a “one size fits all” approach as each community served by a hospital is unique. TGA team members are always accessible to discuss each case with hospital billing staff. TGA’s application of continually evolving methods and processes increase recovery (based on actual history). TGA maintains ongoing filing of revised claims or additional information when required by insurer. TGA continues to follow up to track status and ongoing action to obtain payment of hospital claims as quickly as possible, while documenting activity on the hospital’s system, making real time information available.
TGA’s Third-Party Liability claims recovery department takes immediate action upon referral of an account with Hospital Liens being filed within Twenty-Four (24) hours after all pertinent information has been received. TGA develops relationships with lawyers in the area and makes settlement negotiations more smoothly.
TGA’s Workers’ Compensation claims recovery department will shorten the time it takes to recover Workers’ Compensation claims. TGA has established a consistent record of recovering Workers’ Compensation payments within Forty-Five (45) days of receiving all information required to file the claim.
The difference between what TGA does and what others in this field do is derived from diligent and consistent investigation of the facts underlying each claim. Additionally, TGA has developed software and efficient procedures that both shorten recovery time and consistently track all claims. These processes, procedures and software are continually updated and improved.