Claims Reconciliation


Comprehensive and Cost-Effective Claims Reconciliation

FDS eConcile® is a cost-effective way to assist pharmacy staff in managing third-party receivables and monitoring third-party payments on prescription and DME claims. Perform reconciliation like you have always wanted to but never had the time or manpower. There is no software to install or maintain.

 

Cloud-Based Receivables Management

With eConcile, reporting is readily available for you, your office manager, your bookkeeper, your accountant or anyone you select to manage this critical part of your pharmacy business. eConcile’s secure online reports let pharmacies identify slow-paying third parties, missing claims payments or checks and partially paid claims.

  • Verify Third-Party Payments
  • View Claims Payment Discrepancies
  • Pinpoint Unpaid Claims
  • Track Open Receivables To The Claim Level
  • Measure Payor Performance

 

eConcile Reporting

Secure online reports to help you identify:

  • Slow-paying third parties
  • Missing claims payments or checks
  • Partially paid claims
  • Third-party processing fee reporting

eConcileChart

 

Reconciliation Process Flowchart (click to enlarge)

 

How eConcile Works

  • FDS automatically collects your electronic remittance advice (835 files) to load into the eConcile engine.
  • Any paper remittances received will be uploaded by FDS.
  • All third-party payments received are posted into eConcile.
  • FDS matches the posted payments to the prescription claims and highlights discrepancies once the claim is reconciled.
  • Management reports are provided for review.

Service Levels to Meet Your Needs

eConcile Complete
  • For those customers wanting to outsource their entire reconciliation process, FDS provides claim reconciliation services for manual and electronic 835 remittance advices.
  • With this service, the pharmacy simply verifies their payments and FDS handles the remaining reconciliation process.
  • You receive periodic reports to review your third-party claims cash flow or you can login to your secure eConcile web service from anywhere any time.
  • Spend more time with your patients while FDS manages your third-party receivables.
eConcile Auto
  • For those clients who prefer to manage their claims themselves, FDS offers a comprehensive reconciliation service built on the same platform our FDS Recon team uses.
  • FDS automatically collects available electronic EOBs (835s) from payors.
  • eConcile automatically matches the pharmacy’s posted payments to the prescription claims.
  • The customer is responsible for reconciling their claims through the FDS secure EZ Data Warehouse with basic FDS support for inquiries.

eConcileChart

Reconciliation Services Chart (click to enlarge)

 

Getting Started

  • Pharmacy contracts with FDS to provide reconciliation services.
  • FDS manages the setup of the claims data flow into eConcile.
  • FDS contacts PBMs on your behalf to retrieve the necessary payment files (835s).
  • FDS staff contacts the pharmacy to schedule online training and review reporting options.

Request a free demonstration