A solution for pharmacies that want to improve their medical-claims billing efficiency, revenue, and customer satisfaction.
Connect to a broad network of commercial and government payers directly from your pharmacy-management system to bill medical claims.
Access real-time eligibility information, including for Medicare Part B, Medicaid, and commercial plans, to determine coverage for immunizations and DME supplies and rentals.
Use advanced, front-end editing capabilities to help prevent denials and accelerate reimbursement.
Receive messaging prompts at the point of service when a customer is eligible for immunizations, driving sales and satisfaction; receive prompts when your DME pricing is below a plan’s allowable amount.
Improve denial and appeal processes for DME claims to recover revenue faster and to help prevent future DME denials; specialists manage physician and pharmacy outreach to obtain compliant documentation.
Optimize compliance and audits by engaging our specialists to obtain physician records and completed documentation and to manage claims to final determination.
Average audit success rate
Overall Medicare payment rate
Medicare Audit & Documentation Compliance
Pharmacists and pharmacy staff: learn how to be better prepared for an audit while earning Medicare Audit Compliance continuing education credit (CEC).