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What We Do 2017-10-26T11:56:08+00:00

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OUR SOLUTION

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Automated HealthCare Solutions (“AHCS”) is a leading provider of technology-enabled dispensing solutions for physicians serving workers’ compensation patients and patients covered by personal injury protection insurance. AHCS has developed a powerful, next generation claims management technology platform, called ezDispense™ for point of care medication dispensing. The platform enables the Company to remove many of the traditional barriers associated with physician dispensing, while virtually eliminating reimbursement risk and ensuring patients receive their medication. Unlike other physician billing services, AHCS is able to assume the collection risk on claims and guarantee reimbursement to its physicians. This enables physicians to do what they were trained to do… practice medicine!

CONVENIENCE
AHCS’ programs ensure that your patients receive their medications and test results while in your office. Our programs are user friendly and can be performed with your existing staff in less than 60 seconds per patient. The flexibility of our software allows us to work with practices of all sizes. Whether you are a large health care system with multiple locations or a solo practitioner, we can customize our technology to fit your needs. As a medical professional, caring for your patient is your top priority. You chose patient care because you wanted to help people. By dispensing medications onsite to your patients you are saving them the frustrating and often costly trip to the pharmacy. Onsite dispensing provides your patient with additional confidence in you and your practice.

Outcomes
National studies from the insurance industry (NCCI) have proven that physicians who dispense medication prescribe a much higher percentage of generic medication. High generic fill rates, improved outcomes and subsequent decreased need for litigation are three major reasons why physician dispensing benefits everyone (patients, employers and carriers) and reduces the overall costs of workers comp claims. With the training and support offered by your AM as well as others on the AHCS team, you will never feel like you are alone. Your AM will be as involved as you want them to be and available and onsite as needed.

Compliance
Our ezDispense™ medication dispensing software, powered by AHCS, provides the tools to our physician partners to remain in compliance with all state and federal regulations as well as prescription drug monitoring programs. ezDispense™ electronically tracks all pedigree papers, lot numbers, expiration dates and controlled substances with line item reconciliation. Our software also identifies the location, physician, dispenser, cost, profit and date of all medications dispensed. All medications are tracked by NDC# to ensure appropriate pricing is applied to the medications dispensed. Your Account Manager in conjunction with our corporate legal team is continuously updating the regulations for your state to provide you the tools to make sure your practice is compliant at all times. This is part of the training provided by your AM. Together we work to stay compliant and updated on constantly changing regulations.

PRACTICE INTEGRATION
As a company we understand that you are already pulled in a thousand directions and adding one more task to your day seems impossible to manage. With AHCS you are actually entering into a partnership and will never be left alone to “figure things out on your own”. We pride ourselves on being the most practice friendly company in the industry by offering onsite, personalized support from a devoted Account Manager.

This individual is assigned to your practice and will provide the following services:

  • Staff training will make the program fit seamlessly into your practice without overloading your staff and adding stress
  • We customize the implementation of our program to fit into your clinics existing work flow
  • Consult and educate you and your staff on your state and federal regulations
  • Implement protocols to maintain compliance
  • Notify you if your system is missing information required to bill for the professional component of your workers’ compensation claims
  • Set up office dispensing area
  • Customize end of month financial reporting
  • Continual support and site visits to maintain compliance and structure

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WIN WIN SOLUTION
The Company’s has proven value to physicians, patients and payors in the workers’ compensation segment of healthcare. AHCS can help reduce overall workers’ compensation system expense, rather than shifting cost to any single constituent. At the same time, AHCS serves as a strong patient advocate, providing solutions that improve care and convenience, that can help return the patient to work more quickly.

Value to Patients

  • Greater convenience and eliminates the risk of any out-of-pocket expense associated with filling prescriptions at the pharmacy
  • Improved therapy compliance that can lead to faster return to work
  • Immediate initiation of treatment by ensuring the patient’s first prescription is filled

Value to Physicians

  • Increases patient compliance by ensuring prescription is filled
  • Eliminates the complexity of the billing cycle for physicians and staff
  • Timely, guaranteed reimbursement to physicians virtually eliminates out-of-pocket risk
  • Improves patient convenience and thus satisfaction
  • Provides automated inventory management support
  • Guides physicians through complex regulatory landscape and intricate state-level workers’ compensation and DEA rules
  • Role as complete care manager enhances relationship with the patient
  • No upfront cost to physicians
  • Eliminates time-consuming physician communication with pharmacies

Value to Payors

  • Helps reduce indemnity and medical costs through its high quality physician network that return patients to work more quickly
  • Drives utilization of cost-effective generics at the point-of-care
  • Reduces litigation expense associated with patients being forced to pay out of pocket for medications
  • Improved data reporting compared to other “out-of-network” solutions

Value to Employers

  • Streamlining the continuum of care helps the patient reach Maximum Medical Improvement and returned to work as quickly as possible

PROGRAM BENEFITS

EMPLOYERS
Workplace injuries are certainly bad news for you and your employees. Point-of-care medication dispensing can lead to a quicker employee recovery, less medication dispensed throughout the duration of the claim, fewer unnecessary procedures and an earlier return to work. This not only benefits the injured employee, it also benefits the employer who is tasked with managing healthcare costs while ensuring business demands are still met. It is in everyone’s best interest to get the injured worker back on the job as soon as possible. Point-of-care medication dispensing improves the quality, timeliness and cost-effectiveness of health care in today’s workers’ compensation market.

Immediacy:
The sooner an injured worker starts receiving proper medical treatment, the earlier he or she can get back to work and the less time an employer needs to find additional assistance to cover the injured employee’s workload. AHCS works hand-in-hand with stakeholders to make it easier for patients to obtain their medications immediately which accelerates their road to recovery.

Affordability:
Physicians often dispense the same formulary of medications as pharmacies, with the cost-saving benefit of generics where possible. AHCS can work within all formularies determined by an employer, a third-party administrator (TPA) or a pharmacy benefits manager (PBM) to further effectuate desired cost-savings. AHCS can also electronically submit prescription bills for the physician, streamlining the process for everyone.

CARRIERS
AHCS continues to enter into strategic partnerships with many carriers and PBMs throughout the nation. AHCS can work directly with your PBM to foster cost savings and streamline your processes.

Cost Containment:
AHCS has established a provider network across the country, with agreements in place to ensure that the costs associated with physician dispensed medication are reasonable and appropriate for the marketplace.

Electronic:
Our claims processing system can be seamless and paperless, utilizing the electronic transfer of information to expeditiously process prescription medication claim information.

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PHARMACY BENEFITS MANAGERS
A key to the success of the AHCS model is to work closely, and in tandem, with the stakeholders in the workers’ compensation arena, including PBMs. AHCS is establishing relationships and contracts with many of the nation’s largest PBMs, and the result is competitive cost- savings for prescription medications and proper state reporting (if applicable).

Electronic Billing:
PBMs particularly benefit from electronic billing that is a part of the AHCS process. AHCS has the capability to transmit prescription medication claim information electronically through HL7, 837, ANCI 5010, or via other requested formats, thereby eliminating manual processes for the PBM and reducing overhead costs.

Customization:
AHCS’s program allows PBMs to designate formulary parameters and other rules to effectuate client cost-savings.

THIRD-PARTY ADMINISTRATORS
AHCS works with TPAs to make sure prescription medication claims are appropriately processed. We work with each TPA’s pharmacy benefits managers and clients to create a program that will electronically follow protocols at the point of care, as set forth by the individual clients. AHCS can easily implement individualized programsfor each client.

Electronic:
The use of electronic processing of prescription medication claims through the PBM or bill review process allows TPAs to analyze pharmacy costs on a client-by-client basis through our batch processing solution.

Savings:
Through our processes, TPAs can identify hard savings through AHCS’ negotiated national contracts. This enables TPAs to effectively demonstrate meaningful results to their clients.