How to invite a colleague to your organization
MembersAccessGetting started
Add somebody to your organization by recording their work address, then confirm the invitation is waiting under the Invited view.
Attergo Knowledge Center
Practical guidance for healthcare operations.
Standards, workflows and definitions for pharmacy, billing, compliance and authorization teams, each one cited to its source.
How to use this library
Learn a concept
Definitions, worked examples and cited standards for the topics that need a shared vocabulary.
Design a workflow
Decision models for turning an operational problem into work that somebody owns.
Evaluate an interface
Vendor-neutral context on systems, standards, integration limits and the evidence they require.
Permanent collections
How to
Step by step guides for the work people actually do in Attergo, written from journeys that were run rather than from what the screens appear to offer.
Getting startedDaily workStep by stepOperators
Revenue integrity
How to measure the gap between what a claim should have paid and what it did, explain the gap, and recover it.
Margin leakageUnderpaymentsReconciliationPayer contracts
Pharmacy economics
What a pharmacy pays for medication, what it collects for dispensing it, and how long the money sits in between.
Acquisition costWholesalersPSAOsInventory economics
Provider status & clinical services
Licences, enrollments, affiliations, and documentation, and how each one decides whether clinical work can be billed.
Provider statusCredentialingImmunizationsMTM
Managed care operations
Authorization turnaround, network oversight, claims operations, and delegation evidence for health plans and their delegates.
Authorization operationsNetwork oversightDelegationClaims operations
Medical billing
Clinical-service claims from encounter to payment: documentation, eligibility, submission, adjudication, and posting.
837P835EligibilityIncident-to billing
Prior authorization
Request intake, payer decisions, appeals, and the separate deadlines that govern each of them.
ePAAppealsDenialsWorkflow design
PBMs & reimbursement
The contract terms, pricing benchmarks, and post-adjudication adjustments that set what a pharmacy is actually paid.
GERBERAWPNADAC
DSCSA
Tracing obligations, EPCIS data exchange, verification, and what to do when a record arrives incomplete.
TracingEPCISVerificationExceptions
Compliance
Turning written policy into controls that produce evidence and get reviewed by someone accountable for the result.
HIPAADEAUSPRisk management
FHIR
Resources, REST conventions, implementation guides, and bulk data, and where each one fits an operational workflow.
ResourcesImplementation guidesRESTBulk data
Healthcare interoperability
HL7, NCPDP, and X12 in practice: what each standard carries and what it leaves to the implementer.
HL7NCPDPEDICanonical models
Pharmacy operations
Dispensing, purchasing, clinical services, and cash management run as one daily workflow.
WorkflowStaffingPurchasingCash flow
Audit readiness
How to answer a PBM, payer, regulatory, or internal audit with complete evidence and a defensible record of the response.
Evidence managementRecoupmentsResponse workflowsAudit packages
340B
Eligibility determination, inventory accumulation, diversion controls, and the records that support each decision.
EligibilityAccumulationsDiversionAudit support
Inventory
Item identity, demand, purchasing, expiry, and counting, for organizations holding medication stock.
TurnsShortagesAcquisition costExpiry
Where to start
Get the question right first.
What happened, what should have happened, what evidence would establish the difference, and who decides what happens next.
Recently revised
How to work an underwater fill and acknowledge it
MarginUnderwater fillsDaily work
Open a margin flag, read the economics that produced it and the rule that raised it, and record that somebody has seen it.
How to find a claim and read what happened to it
BillingClaimsDaily work
Open the claims queue, find the claim in question, and read its own record rather than reconstructing the story from memory.
How to open and work a prior authorization case
Prior authorizationCasesDaily work
Find the case, read where it is, and move it along the board so its position matches reality.
How to build a report and have it arrive on a schedule
IntelligenceReportsScheduling
Choose what the report reads, save it, and turn it into something that arrives without anybody remembering to run it.