Trisus Medication Analytic Solutions

Trisus Medication Financial Management assesses purchase, billing, and remittance data sets to provide visibility into margins, at the medication level, giving pharmacy leaders the insights needed to make informed business decisions on a multitude of pharmacy-related areas.

With Financial Management providing a full financial picture, pharmacies can:

• Make medication-related decisions around site of care, payor, therapy, and infusion lines
• Improve margins for medication and inform biosimilar adoption strategy
• Compare margins across payors
• Quickly identify unexpected reimbursement variances
• Decide if and where new infusions centers should open
• Expand and grow specific service lines
• Address issues with workflow, policy, and payor agreements
• Focus on specific medications and payors to maximize financial impact of claim audits
• Save hours each month of staff time on curating data and reports
• Analyze and report medication remittance data across payor types and for focused groups of high-cost medications down to the NDC level.

As hospitals continue to recover from financial losses from the pandemic, a focus on margin management can help improve pharmacy financial performance. Trisus Medication Financial Management helps the pharmacy leaders of today take a more robust, analytic approach to business decisions and strategy.

As medication purchasing patterns change due to shortages, safety alerts, new drug approvals, and more, the formulary can easily become outdated causing under-billing and compliance issues. Trisus Medication Formulary combines data from the formulary, charge transactions, and medication purchases to ensure all purchases are captured in the formulary, coded, and charged correctly.

With Trisus Medication Formulary, pharmacy leaders can ensure:

• Purchased medications not found in the formulary are identified
• Correct coding and charging information for medications
• Proper NDC is attached
• Accurate billing units are notated
• Medication charges are not lagging behind costs
• Accurate cost reporting

As part of the Trisus Medication portfolio, Formulary is designed to analyze the formulary and improve charge capture, compliance, and cost accuracy to drive optimal pharmacy financial performance.

There’s no understating the impact that delayed or denied claims can have on your organization’s bottom line. Trisus Medication Claims is designed to help you accelerate payment for pharmacy claims and minimize claim denials, while managing complex, government-mandated reporting requirements.

The solution’s sophisticated rules engine streamlines the adjudication process by automatically modifying claims based on your configurations, flagging errors and rejections, then re-validating with real-time edits you make directly in the application. Further, your modifications are incorporated back into Trisus Medication Claim so future claims will adjust correctly without manual intervention, continually reducing the percentage of rejected claims over time.

Trisus Medication Claim helps your organization:

• Automate 340B reporting requirements for Medicare and Medicaid
• Reduce delayed, denied, and unpaid claims
• Process claims quickly and efficiently while remaining compliant
• Automatically adjust medication claims based on any number of rule sets
• Edit NDC codes, modifiers, and prices on demand
• Link NDC charge information to current drug purchases

Trisus Medication Compare helps pharmacy leaders leap to value-based care by comparing treatments, medications, processes, and costs to help identify treatment plans that achieve the best patient outcomes. This application empowers clinical staff and P&T committees to yield data-driven improvements in quality metrics such as average length of stay and 30-day readmissions.

• The Pop-Builder RxFM dashboard provides comparative analyses between selected cohorts and real-world data index of over 140 million longitudinal patient records.
• The Variance Reporting feature uncovers micro-level differences on medication utilization metrics, then helps identify the need for formulary adjustments, especially high-cost, high-volume medications.