What happens to your 340B savings when a specialty referral leaves the building?

We match every claim back to the referral that generated it. Our AI patient matching runs 40+ configurations against the things that actually break eligibility: name mismatches, new clinic locations missing from the EMR feed, phoned-in scripts, timing gaps between your EMR and the pharmacy. Anything that can't be tied to a documented referral and a consult note doesn't get captured. That discipline is why we've gone ten years with zero confirmed HRSA findings on referral claims.

Two ways, and you need both. Up to 85% AI automation reads your EHR and referral data to surface eligible specialty referrals as they happen. Then Enhanced Match Claims cross-references incoming claims against your encounter and prescriber records, recovering eligible fills that didn't match the first time. The second half matters more than people expect: most leakage isn't a referral nobody saw. It's a claim that didn't match cleanly.

Yes, through Apollo, our program intelligence platform. You see referral capture by specialty, by pharmacy channel, and by claim, in one view. What you can't get anywhere else is the comparison: Apollo benchmarks your program against 800+ covered entities, so you learn whether your capture rate is good, not just what it is. Mission Control is the team of 340B specialists who act on what it shows.

Then it wasn't captured, it was recorded. A referral claim is only worth what it survives. Every claim NuReferrals captures carries the referral, the consult note, and the fill, documented together and defensible on audit day: zero confirmed HRSA findings in ten years across 1.5B+ claims processed. One health center left for a lower rate, ran an internal audit, found that the claims missing documentation traced to the cheaper option, and came back.