Introducing RC Claim Assist (Releasing in September 2016)

There is a growing trend in physician administered drugs submitted to the medical benefit. Billing at the NDC unit is becoming the new standard. While the use of an NDC has long been a requirement for many payors, it is becoming more prominent for physicians to now include the NDC Billable unit.

After conducting a recent survey with our payor clients, nearly 50% are addressing the use of NDCs for various reimbursement metrics. This NDC initiative requires a comprehensive approach from developing policies, databases and most importantly through provider education.

Source: RJ Health Systems Payor Survey, March 2016
Source: RJ Health Systems Payor Survey, March 2016

Physicians may be unclear of how to submit the correct NDC billable units. Likewise, payors may lack the resources to demonstrate the conversion from HCPCS/CPT code level units to the appropriate NDC units. Ultimately, a consistent process helps both groups drive towards operational excellence and supporting the revenue cycle.

RJ Health Systems has created RC Claim Assist as the single solution for both groups. A web-based application, RC Claim Assist is designed to help providers through the conversion process to ensure the correct HCPCS/CPT Code, NDC and NDC Units are submitted on a claim. This means a reduction in claim errors during the adjudication process and fewer claims under appeals review.