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Split Billing

PharmaForce gives pharmacy leaders complete control over order splitting, crosswalk accuracy, and audit readiness, built for the operational complexity of DSH, CAH and health system environments.
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Most Hospitals Don't Have a Split Billing Problem. They Have A Visibility Problem.

Orders are splitting. Claims are moving. Replenishment is happening. Where things get complicated, and where most platforms quietly fall short, is everything around the split. 

  • Keeping crosswalks current as your formulary evolves
  • Knowing exactly why a claim routed the way it did
  • Running a multi-entity system without losing site-level precision
  • Being able to walk into an audit with documented evidence of configurations

That's where the real work lives. And that's exactly what PharmaForce Split Billing was built for.

THE OPERATIONAL REALITY

Most Split Billing Platforms Were Designed For Simple Programs

Your Formulary Never Stops Changing
New NDCs, manufacturer restrictions, formulary updates — your crosswalk has to keep up with all of it. In most platforms, that means manual rebuilds. In PharmaForce, it doesn't. 
Your Health system Has Layers
Central distribution. Multiple entities. Different site configurations. What works for one hospital doesn't automatically work for a system. PharmaForce was designed for the system.
Your Auditors Want Documentation, Not Explanations
When HRSA or a manufacturer comes asking, the answer can't be "let me pull that together." PharmaForce gives you a complete, timestamped configuration record.

A Split Billing Program Your Team Can Actually Trust

Powerful Crosswalk Tools Every NDC addition, CDM change, or formulary update is a potential mismatch. Use our mapping queue and automations to make mapping easier, so every dispense routes to the right account, every time.  
2 & 3-Way Order Splitting

340B, WAC, GPO — every entity runs a different account structure. PharmaForce supports both 2-way and 3-way splits, configured to your entity type and restrictions. Every order routes correctly. Automatically. 

  
Central Distribution Support

Centralized inventory is efficient — until 340B compliance enters the picture. PharmaForce tracks each site's utilization and replenishes against the right account across every 340B and non-340B location in your system. No commingling. No compliance gaps.

 
Advanced SELF-AUDIT TOOL

Generate a claim-level audit by date range, account type, and sample size — flat count or percentage — review results record by record, and export. All built in, all on your schedule. 

 

  
Multi-EDI Support

Multiple EDI integrations keep your replenishment workflow running regardless of any single connection's health. Flexible by design, resilient by default. 

  
Complete Claim & Configuration Visibility

Full visibility into all of your claims, split logic, claim routing, and configuration history — so you can explain every decision to an auditor.

  
Proactive Issue Alerts Receive automated emails when Pharmaforce notices blocked transactions or unshipped orders to keep your supply chain healthy.  
Audit-Ready Change Logs See a detailed view of modification history, effective dates, and active/inactive status for every configuration change, so you can provide evidence for why a claim routed the way it did with confidence.  
Make Critical Program Changes Without Tickets Manage service codes, payor exclusions, patient types and location eligibility directly within the PharmaForce platform, because managing your program shouldn't require submitting tickets.  
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MEET CLAIRE

Your 340B Agent, built directly into your platform. Ask Claire how to complete a workflow, understand a configuration, interpret accumulator logic, navigate mapping and crosswalks, or find the right report. She brings 340B guidance into the exact place your team is already working.

  • Get Answers Faster
    Ask 340B and Split Billing questions without digging through documentation.
  • Navigate Complex Workflows
    Get guidance on configurations, mappings, accumulators, reporting, reconciliation, and more.
  • Work Where Your Data Lives
    Claire is integrated directly into Split Billing 3.0, so support is available inside your everyday workflow.

Learn More

Your Split Billing Program Should Be Your Strongest Compliance Asset

Let's make it one.

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