Validate Prescriptions, Protect Patient Privacy and Reduce Exposure to Risk

Increase efficiency and mitigate risk by incorporating LexisNexis® Risk Solutions pharmacy data management solutions into existing workflows.

Pharmacy

1-866-396-7703

Contact Us

Validate Prescriptions, Manage Patient Data Better and Reduce Exposure to Risk.

pharmacyProviding high-quality care provision—enabled by a personalized approach, efficient workflow, and data-driven decision-making at the point of service — continues to be the top objective for pharmacists and healthcare providers at large. Improved treatment outcomes tomorrow originate with a deeper understanding of what the data is telling pharmacies today.

Healthcare challenges can be solved, in part, by the application of accurate, rich, and well-integrated information that facilitates better decisions. A successful pharmacy future relies on the synthesis of data, technology, and personal care delivery for optimal care coordination and outcomes. 

Challenges We Address

Patient Engagement

Improve health outcomes, reduce costs, and increase satisfaction with care.

Healthcare Compliance

Ensure that your organization is compliant with all relevant federal, state and industry regulations.

Provider Data Quality

Grow revenue and improve workflows and outcomes with accurate data.

Data Security & Access Management

Ensure people access the right data, while maintaining a positive patient experience.

Pharmacy Workflow Benefits

pharmacyPharmacies need to fill prescriptions quickly and accurately. VerifyRx™ provides real-time compliance on prescription transactions before transmitting to payers, helping pharmacies reduce risk and optimize reimbursement.

This workflow optimization tool helps mitigate the risk and exposure, drives compliance, reduces costs related to claim filing, fines and takebacks, as well as supports overall pharmacy operations.

As part of the pharmacy workflow, VerifyRx processes millions of transactions a day, updating comprehensive prescriber data in real-time, including Drug Enforcement Administration (DEA), State data (when available) and daily National Technical Information Service (NTIS) data.

This highly configurable and responsive tool provides real-time sub-second response on multiple compliance checks for all prescription transactions before transmission to payers, helping retail and specialty pharmacies reduce regulatory risk. VerifyRx identifies potential claims submission errors prior to dispensation and helps Pharmacy Benefit Managers (PBMs) increase the percentage of paid prescription claims.

Managing Data Integrity

pharmacyInconsistent and erroneous or outdated data remains a major challenge for retail pharmacies nationwide. Many pharmacies invest a lot of time and effort trying to solve this growing problem, dealing with the fallout of compromised quality and poor resource allocation. Manually checking provider data on federal and state websites takes multiple steps, leaving room for error and inefficiency. It’s also a very reactive approach to managing information-powered functions. Payer payment recoveries can also happen in case of errors, creating an additional negative financial impact on pharmacy operations.

An alternative approach to manual verification is automating verification and monitoring of healthcare provider licensing and credentials. Comprehensive batch and real-time technology solutions can streamline a variety of provider verification searches and ongoing monitoring options. They can also provide automatic red flag alerts for a wide range of high-risk indicators.

The scope of the challenges pharmacies face when using poor provider data is significant. It’s a frequent area for mismanagement which often results in both fraud and improper payments. Provider Data Enhancements offers pharmacies not only data-handling cost efficiencies but also workflow time savings when operating with correct, current and comprehensive healthcare provider data.

Provider Data Enhancements reduces the IT burden associated with ongoing data management efforts and makes claims processing more efficient through increased auto-adjudication. By identifying and replacing inaccurate, duplicate, and incomplete records, pharmacies can ensure they have the most current provider data to enable quick and efficient prescription claim processing.

Patient Identity Management

As pharmacies work to meet operational challenges including regulatory demands, error reduction, and safety requirements, they’ll need to balance patient needs with business demands. Automation is vital for this endeavor. Correct patient identification is the starting point to a smoother, integrated workflow process that grants providers more time for the tasks that matter most.

Pharmacies need to be able to accurately link patient records and prescription profiles to prevent wrong-patient errors. Mismatches and duplicate records jeopardize patient safety and raise healthcare costs. They can lead to incorrect diagnosis and treatment—including prescriptions—redundant tests and services and productivity loss.

Universal Patient Identifier for Patient Record Linking

pharmacyInaccurate patient identification continues to be a major problem not only in pharmacy but in healthcare overall. Due to the lack of patient data standardization and a plethora of fragmented patient records, duplicate, mismatched and incorrect record problems plague all providers. Obstacles to correct patient identification and complete record access lead to prescribing errors and, subsequently, patient harm.

The industry simply can’t maintain existing practices allowing for wrong-patient errors or dispensing incorrect medication as it continues to work toward better outcomes. LexisNexis Risk Solutions proprietary linking technology analyzes public and proprietary records from disparate data sources and ultimately links together records common to a single individual, assigning that individual a LexID®

The LexisNexis LexID® serves as a unique patient identifier (UPI) and enables better patient management by matching and maintaining a unique identifier for every single patient. Our technology analyzes public and proprietary records from disparate data sources and links them together as a common record.

This type of automation enables a level of data accuracy that human efforts simply cannot achieve initially or maintain overtime. With the adoption of a UPI and continued progress towards true interoperability across providers, the pharmacy, and other care teams, patients will be accurately identified and treated with a “complete picture” perspective for better wellness and disease management.

Patient Outreach and Engagement

pharmacyLexisNexis KeepContact™ maintains the accuracy of patient demographic and contact information so pharmacies can strengthen their outreach and engagement programs to improve wellness in their communities.

Improve Patient Outcomes with Social Determinants of Health

pharmacyAs retail pharmacies increase their visibility in the community, they have enormous potential to improve health outcomes and expand their role within the patient care team. By employing social determinants of health, pharmacies can better understand their patients’ struggles, motivations and limitations, enabling them to better engage with each patient in a way that improves their care while solidifying the role or the pharmacy in driving community health.

Socioeconomic Health Attributes insights can help provide insights on the conditions that affect patient health – the environments in which patients live, learn, work, and play. Having this granular view of patients’ lives is essential for the pharmacists and other clinical care providers to address possible barriers that stand in the way of optimal treatment.  

It all comes down to embracing a holistic model of patient management. The time has come for a transformation in how pharmacies think about care: from a reactive or symptom-based set of responses to a proactive path that leverages data-driven engagement with individuals. By building a corporate strategy that’s based on wellness, pharmacies can establish a welcoming environment that values lifestyle management for each patient.

 

Other Healthcare Capabilities

Payer

Data solutions help plans ensure the right people receive the right care by the right providers at the right cost.

Provider

Data management and intelligence solutions improve market share, reduce risk and safeguard patient identities.

Life Sciences

Data management and market intelligence solutions offer life sciences organizations a healthy market advantage.

Other LexisNexis Healthcare Solutions

Insights and Resources

Research

COVID-19 Healthcare Data Insights

White Paper

The Role of the Pharmacist in Patient Engagement

White Paper

Pharmacy Information Management Is Key to Success

Infographic

Validate Prescriptions to Stay Compliant Using VerifyRx

White Paper

Specialty Pharmacy Compliance Challenges Can Be Mitigated with Real-time Checks

Video

Verify Prescriptions with VerifyRx

Partner with LexisNexis Health Care

We believe in the power of data and analytics
to manage risk & uncover opportunity.

The Role of the Pharmacist in Patient Engagement

Pharmacists are now involved in meaning­ful patient engagement to help improve their patients’ health.
Learn More