PDE Reconciliation
Due to the complexity of Part D, PBMS and health plan Pharmacy Operations, IT, Enrollment, and Finance must work together to achieve successful PDE processing.
It takes an experienced, knowledgeable, strong cross-functional team to successfully manage this vitally important operation. GHG can help you optimize PDE processing by bridging these gaps through a combination of expert guidance, staffing and proprietary reconciliation software. The result will be higher levels of performance for your health plan customers, a critical competitive differentiator in this crowded market.
The heart of our solution is Valencia, a software tool that serves as a single source for CMS membership, payment and reconciliation data. Valencia also connects PDE data with the critical annual Part D estimated settlements. Whether speaking of our technology or our professional services, GHG's solution will be designed around identifying and fixing the root cause issues, thus reducing the ongoing burden to PBMs responsible for readjudicating PDEs.
For more information, please contact ghg@gormanhealthgroup.com today.
