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Claims Reconciliation

Ensure timely, accurate payments from PBMs to pharmacies

Cervey’s Claims Reconciliation solution for pharmacies is a powerful engine that ensures post-adjudicated prescription claims are paid from payors to pharmacies in accurate and timely fashion.

The user-friendly software automatically collects, digitizes and aggregates all Form 835 payment receipts, then combines and reconciles them with all prescription claims.

Automatically check all aggregated claims

and flag inaccuracies that can slow payment.

Reconcile actual collections

against the claim response of expected payment.

Manage collections from multiple payors

and create associated documents and reports.

Enjoy better drug pricing

through your membership in group purchase organizations (GPOs) by generating pre- and post-edit reports.

Generate pre-edit reports

to ensure that claims are completed in the proper manner to obtain GPO pricing.

Generate post-edit reports

to ensure that payors are adhering to your GPO-contracted rates and terms.

Generate claims reports

to monitor the data and performance of multiple payors.

Import switch data

to align multiple claim formats in consistent fashion, and reconcile all previous-day prescription claims.

Get accurate aging-balance information

so you can notify payors of past-due balances.

Want to learn more? Contact Us