Savvy business owners understand the difference between investments that are nice to have and those that are necessary. For retail pharmacies, electronic claims processing moved into the necessity category long ago. However, many locations continue to operate with outmoded networking solutions that can leave them vulnerable to connection failures or security breaches.
Any pharmacy location that hasn’t had a connectivity upgrade in some time – and those for whom upgrades may have been less than optimal – may be missing out on cost-effective solutions that can ensure rock-solid connectivity. When that’s the case, a simple fix is readily at hand.
Reliable Connectivity: Heightened Expectations
A fault-tolerant connection is a must-have for thoroughly reliable electronic claims processing. “Fault tolerance” refers to a connection’s ability to continue uninterrupted at all times, even when a primary connection fails. For example, if a retail pharmacy communications with a claims processor over the internet, and the internet service provider (ISP) has a temporary outage, connectivity immediately rolls over to a backup network connection. In this scenario, communication with the claims processor continues seamlessly, as if nothing happened.
Because protected health information (PHI) is routinely shared with claims processors, the second must-have for a connection is data protection. At minimum, transmissions should be encrypted, so that any intercepted transmissions will be unintelligible to unauthorized recipients.
Meeting these requirements requires zero in-house technical expertise. A few inquiries of appropriate vendors will reveal immediately if a claims-processing connection is all it should be.
Assessing Infrastructures and Improving System Reliability
Taking the following three simple steps will ensure that claims-processing connections are both fault-tolerant and secure:
- Contact the pharmacy software vendor, and ask what capabilities the software includes for fault tolerance and security in communications. Does it guard against downtime, and how is data protected when in transit? Electronic claims flowing over the internet should be encrypted using TLS 1.2 encryption at a minimum.
- Contact the facility’s ISP or private-line supplier and ask the same questions. What happens if the primary connection goes down?
- Finally, contact the claims processor with the same questions – how does it ensure that data is always flowing and always secure?
If the answers indicate a shortcoming in fault tolerance or security, it’s time to pursue options. Even if all is well today or if connections are upgraded, be sure to periodically check in with vendors to see if newer capabilities exist that need to be considered for even greater protection.
The reason for periodically checking in is that network technology continually advances, and vendors often deliver new solutions that perform even better, and at lower cost, than the solutions they replace.
Today’s networking solutions are inevitably yesterday’s, and nobody wants to unintentionally end up with a solution that’s no longer supported. With just a bit of inquiry from time to time, retail pharmacy operators can rest assured that their claims-processing connections are available at all times, with full protection of their customers’ sensitive information.