Business and Management

Medical Billing – Trailer Records

If you've been following our series on medical billing and more specifically, our series on electronic billing of claims using NSF 3.01 specifications, you have no doubt noticed that there are quite a few records involved with sending a claim to a carrier, whether it be Medicare, Medicaid, or a private insurance company. Well, before we go into explicit detail on the trailer record specifications themselves, a general overview of trailer records is probably in order.

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Digitalize Batch Manufacturing Records with CaliberBRM

Why? Well, unfortunately, even if the individual claims in a submission are clean, meaning no errors or violations, a problem with any of the trailer records can get not just one, but ALL the claims rejected.

The individual records, or claims in a claims file, need to have all the individual I's dotted and T's crossed. But still, that isn't enough. Because all of those individual claims need to be totaled up. In other words, if the sum amount of all your claims comes out to $759.83, then your total record better show $759.83 in total claims and not $759.84. Just one penny off in your totals record and your whole batch, not just one claim, will be rejected.

Totals of dollars are not the only thing that has to be just right. The trailer, or totals records, count up a lot of other things as well. One of the main things that are counted in the trailer records is the actual number, not only of claims but of records themselves.

Business and Management

Electronic Batch Record Solution That Meets Pharmaceutical Manufacturers Needs

EBR systems are software-driven solutions for managing record-keeping and review workflows, which eliminate the time-intensive extraction, checking, and analysis steps associated with paper-based batch record processes.

These efficient and agile systems are not simply an electronic equivalent to outdated paper-based documentation (often referred to as ‘paper on glass’ solutions). Instead, they transform how pharmaceutical manufacturers operate by enabling real-time data collection and ensuring strict execution of batch processes, thereby improving the quality and consistency of data and supporting GMP compliance. Looking to grow its product line, Nephron urgently required a solution.

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However, previous attempts at finding an affordable EBR that met its business needs had proven unsuccessful. Commercially available paperless systems were either pure ‘paper on glass’ equivalents or designed from an automation perspective without the possibility of user-mediated configuration.

Maintaining such a system was complex and required extensive investment in IT resources, which was simply not cost-effective for a small-to-medium-sized company like Nephron. When Nephron discovered that its existing supplier, Lonza Informatics, was developing a new EBR system for pharmaceutical manufacturers — the MODA-ES™ Platform — a collaboration evolved, based on the partners’ mutual requirements. 

The collaborative approach taken by Lonza and Nephron, with parallel implementation and robust testing of multiple beta versions of the software, enabled this expedited software roll-out. Nephron was delighted to partner with Lonza and reports finding their MODA-ES™ Platform to be an affordable solution that delivered excellent ROI.

Reporting on how its performance exceeded Nephron’s expectations, Bryan Beck noted, “The 6-hour review needed for paper batch records was reduced to an hour with the MODA-ES™ Platform, so it increased our efficiency significantly. The MODA-ES™ Review and approve process allows for real-time review as the batch advances through the product lines from formulation through packaging.