Replay – The Story of a Claim

Pharmacy claim adjudication -- one of our healthcare ecosystem's most critical and intricate workflows -- is uniquely complex. Yet, processing a pharmacy claim is often seen as a straightforward task. Why is that?

To answer that question, Capital Rx’s Vice President of Product Management, Kevin Sundquist, eloquently described the journey of a claim, highlighting how our modern enterprise health platform, JUDI®, helps with the administration of pharmacy benefit programs, allowing for the speedy and accurate processing of members’ claims. Can you imagine the potential if additional data – like medical or other claims – are integrated? We can!

Check out the replay and the highlights below and click here for the presentation materials.

Highlights

• The journey of adjudicating a claim (6:00)

• Adjudicating a claim in JUDI (29:45)

• JUDI's "Adjudication Reasons" feature & how it tells the claim's story (33:02)

• The benefit of testing within a single system (41:35)

Related Content

• Replay – The Future of Pharmacy Claims Processing: A Deep Dive into a Modern Adjudication System

• JUDI® is a Tech-Enabler – A Case Study  

• Capital Rx’s JUDI® - The Beauty of an Open Platform

• How Our Favorite New JUDI® Features Aid Pharmacy Benefit Administration

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Want to learn more about Capital Rx’s M3P solution and how it can do all the heavy lifting required to meet CMS’s requirements? Contact our team today!

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