Accounting and Financial Software
WorkingRx and Jopari Roll Out Workers' Compensation Industry's First End-to-End ANSI Processing of Pharmacy Bills
CONCORD, Calif., and SALT LAKE CITY, April 26 - WorkingRx(TM), the premier workers' compensation pharmacy claims processor serving over 24,000 independent and chain pharmacies nationwide, and Jopari Solutions, Inc.,the technology leader in electronic bill acceptance, payment automation and payer/payee portal services for property and casualty industry payers, have implemented with current payers the workers' compensation industry's first end-to-end ANSI X12 electronic processing of pharmacy bills.
Jopari currently is live with e-Bill delivery in California, and will start implementation with ten additional payers in California, Texas and other states within the next sixty to ninety days.(TM)
WorkingRx and Jopari are transitioning customers to paperless processing in light of emerging industry developments ratcheting up demand for electronic processing alternatives. Pharmacy payments as a percentage of all workers' comp medical losses are rapidly growing, with pharmaceutical benefits currently exceeding 8% of medical losses, by some estimates.
According to industry studies, pharmacy transaction costs, billing problems, and delays in payment are industry-wide problems. End-to-end ANSI formatted electronic processing solves inefficiency problems in handling paper and partially converted pharmacy bills.
Additionally, in states where medical e-billing, prompt pay and EDI reporting implementation deadlines kick in beginning January 2008, compliance is a looming issue for payers. Acquisition of technology automating as much of their front and back end processing as possible, has become a major strategic focus.
WorkingRx SeniorVice President of Operations, Kim Miyano, stated, "WorkingRx's number one mission is enabling providers and payors to improve cash flow, integrate healthcare information, reduce claim costs, and improve productivity. Today, with pharmacy benefits assuming an ever larger role in workers' compensation, Jopari's best-of-breed technology supplies WorkingRx with mission critical support we intend to competitively express going forward."
WorkingRx and Jopari's end-to-end ANSI processing architecture for pharmacy bills, payments and electronic explanations of review (EORs) comprises six automation layers:
(1)WokingRx captures prescriptions at point of sale from connected network pharmacies, converts them to ANSI 837 pharmacy format;
(2) Jopari receives and applies robust business rules edit engine to the ANSI 837 bills validating national, jurisdictional, and payer specific edits;
(3) Jopari carries out ANSI processing and delivers data and image files to payer's claim/bill review systems;
(4) Jopari pulls payment extract data and processes electronic (EFT) and paper formatted disbursements with flexible EOR delivery including Web portal presentment, online dispute resolution and active data warehousing;
(5) Jopari delivers ANSI 835s to WorkingRx for auto-posting; and
(6) Jopari carries out state medical EDI reporting compliance services for the payor.
Jim Grim, Senior Vice President of Jopari, said, "Our partnership with WorkingRx is important on several levels, beginning with the fact WorkingRx is a major pharmacy bill processor for workers' compensation payers across the nation and has earned the prestige necessary to lead industry transition into a fully automated processing environment. Our partnership provides leading edge services to our mutual customers, putting them in a position of clear competitive advantage in terms of technology, performance and compliance."
ABOUT WORKINGRX
WorkingRx(TM), Inc. offers products and services to take the "Work" out of Workers' Compensation Claims Management. We help pharmacies reduce administrative time spent on Work Comp claims and increase profits. Our solutions give pharmacists tools they need to offer unparalleled service to their customers, maximize reimbursements, and capture new business. By offering both indemnity and non-indemnity programs, we provide the flexibility necessary to fit needs of both independent and chain pharmacies. Through innovative products and services, WorkingRx enables providers and payors to improve cash flow, integrate healthcare information, reduce costs, and improve productivity. WorkingRx is the complete solution to workers' compensation prescription processing. In addition to Workers' Compensation Claims Management Solutions, we also offer a broad range of Third Party products and services: Specialized Pharmacy Services and Payor Services. workingrx.com
ABOUT JOPARI SOLUTIONS, INC.
Jopari Solutions, Inc. supplies SAS 70 Type II Certified Integrated Compliance and Payment Solutions to Workers' Compensation, Auto, and Health Insurance industry Payers. Jopari significantly improves the technology Payers use to manage bills and disbursements, and substantially reduces associated expenses. Jopari services enable insurance Payers to comply fully with regulatory requirements, including e-Bill and e-Pay jurisdictional initiatives, and HIPAA. Insurance and other industry Payers take advantage of JopariPay(TM) to permanently downsize processing and labor costs, increase operational competitiveness and realize immediate returns on investment.
Source: Jopari Solutions, Inc.
CONTACT: John Roberts of Jopari Solutions, Inc., +1-925-459-5218, john_roberts@jopari.com; or Diane R. Trujillo, VP, Communications of WorkingRX(TM), +1-801-417-6215, diane.trujillo@workingrx.com
workingrx.com
www.jopari.com
