Government Navigation Suite

340B Recovery

Increase 340B savings by identifying missed prescriptions written by both eligible and referred-to providers with a compliance-first, contingency-based solution that works with every TPA and contract pharmacy.

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Recover more 340B prescriptions from eligible and referred-to providers than any other solution

Streamline existing pharmacy operations and maximize 340B program value with Cloudmed’s compliance-first solution that works with every TPA and contract pharmacy to identify and automate what others can’t.

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340B Recovery Overview

Maximize 340B program value with Cloudmed’s compliance-first technology that reviews ineligible claims to find prescriptions written by eligible and referred-to providers. Unlike manual review and solutions lacking centralized data across all pharmacies, our technology is comprehensive, easy-to-deploy, and compliance-focused, as evidenced by Cloudmed’s 100% audit pass rate. Built on the industry-leading 340B Referral Capture technology from par8o, a Cloudmed company.

Cloudmed 340B Recovery is used by pharmacy leaders, finance executives and 340B program managers to centralize ineligible claims review in a single solution.

Automate ineligible prescription review

Small technical errors can cause eligible claims to be misclassified as ineligible. Leverage our technology-enabled service to both review prescriptions written by eligible providers and match outgoing referrals to resulting prescriptions.

Prove referral ownership of care

An outgoing referral in a patient record is only the starting point when it comes to referral prescription compliance. Empower your providers with patient encounter notes from the referred-to provider to both prove prescription eligibility and foster more comprehensive patient care.

Be compliance confident

Developed by experts with over 45 years of combined 340B and pharmacy experience, our compliance approach is verified by our clients’ HRSA audits: 100% of audited Cloudmed claims have resulted in zero findings. We also conduct internal audits to ensure 340B compliance and partner with clients to review policies, procedures, and claims in connection with HRSA audits.

Increase 340B capture rate in fewer than 90 days

There’s zero risk with Cloudmed’s 100% contingency fee-based model. Here’s a look at how we work together:

Startup

You sign pharmacy and TPA addendums and set up daily automated encounter and referral files from your EHR as well as remote, read-only access to your electronic medical record system.

Review

Our technology determines patient, provider, and site eligibility by analyzing EHR and contract pharmacy data. Experienced professionals then manually review each identified script and related documentation to verify proof of eligibility.

Recovery

Integrations with the top two retail pharmacy chains and a growing number of TPAs means most recovered prescriptions are automatically reprocessed as eligible. All others are submitted to you for approval.

Continuous Improvement

Operations professionals consistently review implementation performance from end-to-end to identify optimization opportunities, so you’re always achieving maximum results.

Our technology has unique integrations with Walgreens and CVS pharmacies, in addition to a growing number of TPAs and specialty pharmacies. For all other sources, if you have ineligible prescription files, we’ll audit it against your list of eligible providers and locations. Our technology means we automate what others don’t.

Cloudmed 340B Recovery is not a TPA. Consider us an add-on technology to help you maximize the value you get from existing TPAs. We figure out why prescriptions written by eligible providers were missed and help you improve processes for better future capture rate, and we analyze referral and encounter data to help prove 340B eligibility for referral prescriptions.

Cloudmed and par8o integrated in December 2021 to introduce Cloudmed 340B Recovery to covered entities. par8o’s industry-leading 340B Referral Capture technology is the cornerstone of 340B Recovery, so you can rest assured in the trusted compliance-first approach and industry expertise.

Other solutions are de-centralized and lack integrations with major contract pharmacies. Our 100% contingency-based pricing means you only pay us when we help grow your 340B savings.

Our team expertise amounts to over 45 years of 340B compliance and pharmacy experience, in addition to a 100% audit pass rate on all audited claims. Our implementation is flexible to match your eligibility parameters while conservative enough to ensure all captured claims will meet or exceed HRSA eligibility requirements, including documentation.

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340B Recovery

Recover more 340B prescriptions from eligible and referred-to providers than any other solution.

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Find out how Cloudmed 340B Recovery can help you increase 340B program savings by filling in the form below.

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