LibraRx Standard Reconciliation

The LibraRx Standard Reconciliation Program offers independent pharmacy "transaction level" reconciliation and provides reimbursement audits similar to those the chain pharmacies have employed since 1996. LibraRx compares data received from the pharmacy's switched data (paid claims response) to electronic remittance advice submitted by third party payers.  LibraRx supports reconciliation with all third party payers that offer electronic claims remittance.

To participate in the LibraRx Standard Reconciliation Program, your pharmacy should enroll in the Third Party Station chain network (code #866).  For more information, please contact us toll-free at (800) 460-1575 - Option #3.

LibraRx Standard Reconciliation simplifies your payment process; you’ll receive remittance advice and payment from one source – Third Party Station.

Here's what you can expect from our Third Party Claims Reconciliation:

• Accurate reimbursement from contracted third party payers.
• Daily reports identifying those third party payers that have not reimbursed 100% of the owed amount.
• Central payment and reconciliation for participating pharmacies on third party payers .
• Fast payment via electronic funds transfers rather than mailed checks .
• Easy access to web-based remittance advice reports, aging summaries and deposits.

2010 Success Stories!

Our reconciliation program identified the following payments that were not paid on time or otherwise paid incorrectly. We recovered these funds on behalf of our member pharmacies and deposited the money directly into their bank accounts. We will continue to scrutinize these payers as well as the other payers in our program to make sure that our pharmacies are compensated correctly.

Date	Third Party	Amount	Pharmacies
2010-08-31	WHP Health Initiatives	$604,488.91	803
2010-07-20	HIP of New York	$563,847.59	227
2010-06-29	ProCare Rx	$90.70	3
2010-06-22	Aetna	$2,311.19	4
2010-06-14	Independent Health Corporation-PBM	$2,033.10	1
2010-06-02	LDI	$14,819.43	39
2010-06-02	Medimpact	$199,929.58	387
2010-06-01	Prescription Solutions	$128.90	2
2010-05-25	Aetna	$716.86	2
2010-05-25	Rx America	$1,498.02	1
2010-05-19	Aetna	$23.02	1
2010-05-18	CVS CAREMARK	$925.64	1
2010-05-14	Caremark	$13,018.49	1
2010-05-06	Aetna	$675.66	1
2010-04-29	Aetna	$762.18	1
2010-04-28	Aetna	$808.08	4
2010-04-28	CVS CAREMARK	$888.43	3
2010-04-27	Aetna	$2,330.45	1
2010-04-26	Maxorplus	$4,485.93	46
2010-04-19	CVS CAREMARK	$1,048.58	1
2010-04-12	CAREMARK	$25,573.97	1
2010-04-12	CVS CAREMARK	$704.63	1
2010-03-31	CVS CAREMARK	$1,011.26	1
2010-03-18	CAREMARK	$14,710.63	1
2010-02-24	Aetna	$507.59	1
2010-02-17	Aetna	$204.73	1
2010-01-28	HIP of New York	$674,959.52	507
	Totals:	$2,132,503.07	2,042

Reconciliation Reports
The return on investment for participating in the LibraRx Standard Reconciliation Program can be significant, and it is clearly stated on our reports. It is not our intent to overwhelm our pharmacy participants with data. Once your pharmacy signs up with our program you will be assigned a unique log-in and password that you can use to access your pharmacy’s specific reports.

DEPOSIT – Provides your deposit history and the claim counts posted for each payer over the last 90 days. You can drill down to the claim level on this report as well.

AGING – Claims identified on this report are the claims captured from the switch that were not paid in the full amount agreed to by the third party payer. While PARTIAL PAY claims tend to be small, these claims collectively can result in substantial amounts over time.  It is a good practice to examine the cause of PARTIAL PAY to rule out improper charges such as unauthorized transaction fees or improper network discount reimbursements. This report tracks these claims 0 to 30 days (current) and then at 31-60, 61-90, 91-120 and over 120 day increments. You can drill down to the claim level detail to examine individual claims that have not been paid.