Choose an expected reimbursement basis before measuring variance
Expected reimbursementContractsVariance
A variance is only meaningful when its expected amount has a documented basis, version, and effective date.
Attergo Knowledge Center
Practical guidance for everyday healthcare operations.
Learn how to use Attergo modules, organize work, and complete common pharmacy, billing, compliance, and authorization workflows with confidence.
How to use this library
Learn a concept
Definitions, examples, diagrams, and cited standards for a topic that needs a shared vocabulary.
Design a workflow
Decision models and reference patterns for turning an operational problem into accountable work.
Evaluate an interface
Vendor-neutral context for systems, standards, integration constraints, and evidence requirements.
Permanent collections
Revenue integrity
The mechanics of measuring, explaining, and recovering revenue that should have reached an organization.
Margin leakageUnderpaymentsReconciliationPayer contracts
Pharmacy economics
Operating models, purchasing economics, reimbursement, working capital, and profitability for pharmacy organizations.
Acquisition costWholesalersPSAOsInventory economics
Provider status & clinical services
How provider recognition, documentation, credentialing, and clinical services become payable work.
Provider statusCredentialingImmunizationsMTM
Managed care operations
Practical guidance for health plans and delegated organizations coordinating authorizations, network operations, claims, and oversight evidence.
Authorization operationsNetwork oversightDelegationClaims operations
Medical billing
A practical reference for clinical-service claims, documentation, eligibility, and remittance workflows.
837P835EligibilityIncident-to billing
Prior authorization
Workflow design for requests, decisions, appeals, electronic authorization, and turnaround-time management.
ePAAppealsDenialsWorkflow design
PBMs & reimbursement
The contracts, claims economics, terminology, and audit mechanics that shape pharmacy reimbursement.
GERBERAWPNADAC
DSCSA
Traceability obligations, data exchange, exception handling, and evidence for pharmaceutical distribution.
TracingEPCISVerificationExceptions
Compliance
Operational compliance as a system of policies, evidence, controls, and accountable review.
HIPAADEAUSPRisk management
FHIR
FHIR resources, APIs, implementation guides, and the role of modern data exchange in healthcare operations.
ResourcesImplementation guidesRESTBulk data
Healthcare interoperability
The standards and operational realities behind healthcare data exchange.
HL7NCPDPEDICanonical models
Pharmacy operations
How dispensing, purchasing, clinical work, and finance become one operating system.
WorkflowStaffingPurchasingCash flow
Audit readiness
Evidence practices for PBM, payer, regulatory, and internal audits.
Evidence managementRecoupmentsResponse workflowsAudit packages
340B
Program operations, inventory controls, auditable records, and policy-aware workflows.
EligibilityAccumulationsDiversionAudit support
Inventory
Demand, cost, purchasing, expiry, and inventory evidence for medication operations.
TurnsShortagesAcquisition costExpiry
Start with a durable question
Technology is a tool. The operating question comes first.
Use this reference to make the question precise: what happened, what should have happened, what evidence would establish the difference, and who can decide what to do next.
Recently revised
Why remittance matching belongs at the line level
835RemittanceMatching
Header totals can reconcile while individual claim lines remain misapplied, unpaid, duplicated, or adjusted.
Design a missing-remittance aging queue
AgingPayment cycleExceptions
A claim is not necessarily unpaid because it lacks a remittance today; it becomes an actionable exception when it exceeds a documented payment-cycle expectation.
Acquisition cost is time-bound evidence
Acquisition costInvoicesMargin
A current catalog price cannot explain the economics of a dispense that was purchased under a different invoice, contract, or date.
The pharmacy cash-conversion cycle
Cash flowInventoryRemittance
Pharmacy cash flow is shaped by when inventory is paid for, when a claim is adjudicated, and when payment is actually received.