Claims processing and adjudication are the very heart of what healthcare payers do. Not only do these operations consume the bulk of resources, but performing them accurately and efficiently is central to maintaining healthy profits.
Among the many factors that contribute to a successful claims-processing system, none is more essential than ready access to a drug knowledge base with comprehensive, up-to-date clinical and pricing information. That's why so many payers rely on First DataBank. For over 25 years, we've provided the industry's preeminent drug databases, clinical decision support and customer service. In doing so, we've helped countless payers better manage the complexities of processing and adjudicating claims.
Streamline Drug Claims Processing and Adjudication
A comprehensive drug database for claims processing and adjudication is essential: without it, you wouldn't have the information you need to make sound decisions. You'd find it difficult to determine brand or generic status, as well as exclusions or preferred products for drug formulary management. If your claims-processing system includes drug utilization review, your efforts to clinically screen drug products would be hampered.
Comprehensive Drug Coverage
Those problems are addressed with First DataBank medications databases. We provide the most comprehensive and widely used drug information for healthcare payers—including prescription drug products and over-the-counter product—organized specifically for the ready accessibility that claims processing and adjudication systems require. We facilitate drug formulary management via access to multiple therapeutic classification systems, and the breadth and depth of our drug vocabulary. And we provide detailed sets of data elements for supporting informed decisions about brand versus generic status, and for grouping excluded and preferred products.
Staying Up to Date
In addition, no other drug data is more up to date than First DataBank's. New drug products and information are added to our databases daily. And with a quality clinical, technical and support staff grounded in real-world pharmaceutical experience and drug informatics, we're also extremely responsive to requests and able to address discrepancies promptly.
Essential Building Blocks
In short, First DataBank sets the standard for providing context-relevant drug information for efficient integration into pharmacy claims processing systems.
NDDF Plus is the leader in supplying comprehensive coverage of descriptive, pricing and clinical information on drugs. It encompasses medications approved by the FDA, plus commonly used over-the-counter drugs and information on herbals, nutraceuticals and dietary supplements. Comprehensive and up-to-date are the key concepts here, since drug content is dynamic and notoriously difficult to maintain. The number of drugs on the market has grown exponentially in recent years, not to mention the challenge of daily changes in pricing information. It's essential, therefore, that the drug knowledge base behind pharmacy claims processing systems be the most reliable in the industry. NDDF Plus is that knowledge base.
First DataBank has also created
Multiple Access Points (MAPs), basic drug identifiers that enable all users to zero in on First DataBank drug information quickly and efficiently within their normal workflow. And you can take advantage of First DataBank's proprietary
Enhanced Therapeutic Classification (ETC) system—as well as the American Hospital Formulary Service Classification System—to build or revise clinical and formulary information at as general or specific a level as necessary.