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Split Billing At Hospital Scale Is Complicated.

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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THE REALITY

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.
WHAT GOOD LOOKS LIKE

A Split Billing Program Your Team Can Actually Trust

Not because nothing ever changes. But because when it does, your TPA handles it. 

Crosswalks update. Configuration is visible. Your audit trail is current. And your pharmacy team is running the program, instead of maintaining the tool.

That's the standard PharmaForce is built on.

crosswalk icon 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.  
split icon 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 fill 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.

 
audit icon 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 Multi-EDI Support

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

  
change log icon (2) 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.

  
email alerts Proactive Issue Alerts Receive automated emails when Pharmaforce notices blocked transactions or unshipped orders to keep your supply chain healthy.  
audit icon 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.  
change log icon (2) 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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Your Split Billing Program Should Be Your Strongest Compliance Asset

Let's make it one.

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