Leverage referral claims to find untapped benefit

Referral prescriptions can play an important role in your 340B program’s ability to stretch scarce federal resources — but they’re often excluded due to the complexities of managing referral provider relationships, leaving valuable 340B benefit on the table.

Our Referral Verification System™ (RVS™) leverages your existing Sentrex® platform to access referrals initially deemed ineligible, helping you reclaim eligible prescriptions and capture more 340B opportunity. With no upfront fees, IT lift or new implementations needed, we offer three ways to manage the workflow:

  • Customer Managed RVS (CM-RVS): You review claims in the RVS queue at your convenience during the reprocessing window to confirm the provider-referral relationship.
  • Managed RVS (SM-RVS): Our expert Senturion™ Professional Services team does the legwork and is specifically tasked with helping ensure proper documentation all the way through the patient journey.
  • Hybrid RVS: A combination of CM and SM-RVS services which allows customers to confirm claims for most of their pharmacies while the Senturion™ Professional Services confirms claims for select pharmacies that are not visible to the customer due to contractual agreements. 

Read how two health systems are benefiting with RVS

Did you know that 1/3 of doctor visits per year generate a referral? This statistic represents a significant opportunity when considering the average cost per pharmacy claim is $566 for retail and $6,565 for specialty drugs.

The good news is that reclaiming 340B-eligible benefit though our RVS software is easy and compliant. Hospitals are benefiting from capturing referrals and are learning that enhanced monitoring of referral claims allows for better patient outcomes.