NuvemRx’s Advanced Referral Solution: Driving Referral Capture and Streamlining Documentation Issues

The Company

A community health center in New York started with NuvemRx’s Advanced Referral Program, after an overhaul of their previous model. 

They had started utilizing NuvemRx’s other services earlier in the year but wanted to evaluate the Advanced Referral Solutions’ effect on other health centers by reaching out to colleagues. While doing their research, another center explained to them that 14 of their sites currently brought in equal revenue to what their regular 340B program was generating after utilizing our referral program. The New York-based community health center was also concerned with their limited Medical Records department, recognizing they could not look up referral documentation quickly to validate claims. They knew it was time to begin utilizing referral claims revenue, recognizing that it is an imperative part of the community health centers’ ability to grow and offer effective medical services. 

Benefits

Increased Revenue

Once partnered with NuvemRx, the client was extremely pleased with the way our innovative software increased their 340B program revenue. Referral capture is often an unfamiliar revenue resource that increases not only claim capture, but the overall quality of health center offerings. “We used to profit $80,000 from a very small model we had with another TPA for the past twelve years. We are anticipating, based on current monthly income over the past year, with three pharmacies, a minimum of $700,000 net profit annually.”

Audit Readiness

The goal of NuvemRx’s Program Integrity Service is to help covered entities pass federal audits. Our consultants help you understand specific issues that regulators will likely identify and help ensure clients maintain 340B program eligibility, allowing them to remain part of the program. “We have just begun our first official audit for this past quarter. Back in July, they began a baseline audit to get all our information readied for a 340B Federal Audit. They went through everything with a fine-tooth comb, and we now are prepared to conduct a real first quarter audit.”

Improved Record Access

This health center’s initial concern was their limited Medical Records department, understanding that quick and easy access to referral documentation is imperative for a well-functioning program. NuvemRx’s advanced software allowed employees to find documentation with speed and ease to better serve clients.

About NuvemRx

NuvemRx helps community health providers deliver on their mission by simplifying the complexity of pharmacy operations —with a suite of scalable solutions that integrate software, intelligence and expert support that can illuminate savings, expand access, and elevate patient care.

Our mission is to be the most trusted partner for community health providers.

Why Align With NuvemRx?

The community health center was looking for a partner that had the ability to maximize their 340B savings. With the implementation of NuvemRx’s Adanced Referral Program, they were able to increase savings, be HRSA audit ready, and utilize NuvemRx software to improve record access.