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Pharmacy Claim Processing & Medication Fulfillment

Description

SCRx is a pharmacy based in Southern California whose focus is post-acute care. Previously, the company lacked efficiency due to cumbersome business processes. Their managers were obliged to check PDF pharmacy claims received via email through ZenDesk (a customer support system), then handle the data in another online system to fulfill prescription drug orders. TATEEDA GLOBAL was hired by SCRx to bridge those systems and help them fully optimize, automate, and speed up their pharmacy business processes.  

Challenge

Project Abstract

SCRx hired TATEEDA GLOBAL to implement advanced functionalities and integrations for better performance in their existing custom-developed pharmacy inventory-management solution. 

Specific configurations of drug prices and dosages found in PDF documents needed to be managed in a specific way so a template-based email response would be generated for every claim of that type. Manual search and processing of data in PDF documents was eating up a great deal of valuable time, so automation of this process was among the first tasks on TATEEDA GLOBAL’s list.  

Challenges Faced by the Client

  • Lack of data portability between the existing pharmacy-management platform and ZenDesk’s ticket-management system. 
  • A great deal of manual work, including document checks and manual data input to pharmacy inventory software and emails.  
  • Limited speed and accuracy in SCRx’s high-cost prescription monitoring due to manual operations. 

Project Goals

  • Integrate SCRx’s web-based pharmacy management app with ZenDesk for automated data import.
  • Implement automatic processing of PDF attachments with the help of text recognition algorithms (OCR) programmed to look for specific keywords and generate notifications.
  • Add a series of additional PDF reports, email notifications/alerts, and electronic signature functionality. 
  • Develop a UI component to manage email replies, PDF templates, and alert parameters. 
  • Import and process data from CSV files with alert notifications.

Solutions

TATEEDA GLOBAL delivered the following: 

  • Empowered SCRx’s web-based pharmacy claim-management system to receive and interpret PDF documents from ZenDesk.
  • Added OCR-based processing module to scan PDF attachments for specific types of data (keywords, prices, etc.)
  • Added additional types of PDF reports to be automatically generated based on data found in PDF claims.
  • Added automatic alert notifications when certain prescription drugs and price/dosage combinations are detected (for example, if a daily cost limit exceeds preset levels).    
  • Developed UI panel to manage PDF document parameters and add/remove/update medications, costs, and dosages.  
  • All necessary back-end and front-end API component integrations and QA arrangements. 

Impact

  • Thanks to TATEEDA GLOBAL, SCRx increased the speed and accuracy of their business processes, including pharmacy claim processing and medication order fulfillment.
  • With the process facilitation implemented by TATEEDA GLOBAL, the amount of manual work was reduced to minimal levels. 
Location
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Expertise Custom Software Development

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