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CMS regulations on the organization and submission of medication information are complex and uncompromising. For many healthcare companies, these regulations require a significant investment in time and effort.

SeniorScript clients enjoy an unmatched level of support to meet CMS policies. We automatically categorize each prescription by drug status code, tagging each med according to its status as OTC, Medicare Part B, Part D, and so forth. We conduct periodical clinical reviews to find exceptions according to clinical criteria and configure data to the PDE format. All claims are automatically screened for:


  • Formulary compensability

• Quantity dispensed

• Early refills

• Authorized physicians

• Therapeutic duplication

• Generic substitution

• High dosage or other specific guidelines set forth by claims specialist

We can provide formatted PDE data for you to submit or submit the PDE for you directly to CMS via secure link.

 

 

 

1460 Ann Street • Montgomery, AL 36107 • P (877) 409-2811 • F (877) 409-2911info@seniorscript.com

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