A Tool to Estimate DIR Fees?
The DIR Fee Estimator tool uses claim detail in combination with DIR rates from signed contracts between Elevate Provider Network and pharmacy benefit managers.
Good Neighbor Pharmacy launched a new solution that is meant to help independent community pharmacists manage the impact of direct and indirect remuneration (DIR) fees and the hidden cash flow issues associated with them.
The DIR Fee Estimator tool is available to members of AmerisourceBergen’s pharmacy services administrative organization (PSAO), Elevate Provider Network, who take advantage of its Advanced Features. Good Neighbor Pharmacy officially launched the resource during the General Session at ThoughtSpot 2017, though owners had access to the tool before the annual conference.
“Inconsistency and opacity in how DIR fees are calculated and the delayed timing of DIR fees is a major pain point for pharmacists,” said Chuck Reed, Group Vice President for Pharmacy Innovation and Solutions at AmerisourceBergen, in an interview with Pharmacy Times. “Our goal is to help Good Neighbor Pharmacy owners manage the life cycle of pharmacy claims.”
Good Neighbor Pharmacy leaders unveiled the Elevate Provider Network — the organization’s revamped PSAO – at ThoughtSpot 2015, as part of an effort to help pharmacies improve profitability through enhanced patient care and support better business practices.
The DIR Fee Estimator tool uses claim detail in combination with DIR rates from signed contracts between Elevate Provider Network and pharmacy benefit managers. Since DIR fees vary based on Star Rating measures and other performance criteria, the tool generates high and low estimates of DIR fees, as well as a midpoint — or most likely – estimate for the DIR fee. The tool, which helps pharmacists better anticipate their monthly fees, uses real-time, claim-level data and is updated every two hours to ensure the most accurate information is available.
“We want to empower them to plan ahead, give them visibility into the process and ultimately set them up for a more successful business,” Reed said.
The Elevate Provider Network will continue to evolve as Good Neighbor Pharmacy leaders continue to work with customers. As the company expands its offerings, its priority remains the same: increase the amount of time pharmacists spend with their patients and decrease the time they spend struggling with payment issues.