MedRx™

Smart Messaging alerts your staff at the point of engagement when a customer is eligible for an immunization (e.g. flu, pneumonia, shingles, etc.)

Access real-time eligibility to check a customer’s Part B Medicare coverage and identify other existing coverage

File Medicare Part B vaccination claims as part of your standard pharmacy workflow

NDC (National Drug Code) to HCPCS (Healthcare Common Procedure Coding System) mapping

ICD-10 (International Classification of Diseases) submission

Pharmacy-to-Medicare billing-unit conversion

Customers frequently achieve more than 99% payment rates 

Includes diabetic supplies, ostomy supplies, inhalation drugs and supplies, oncology agents, immunosuppressive drugs and hardware rentals

Help prevent denials by determining eligibility for medical supplies and subjecting claims to CMS policy, format and cardholder edits

Automatic edits help remove the burden for you to stay on top of CMS policy

Use Cross Check to integrate Medicare supplemental data on the front end to help ensure accurate patient collections and avoid customer refunds

Receive messaging at point of sale if your pricing is below the plan’s allowable amount

Simplify billing by submitting your DME claims in the standard NCPDP format using your pharmacy-management system 

SmartRelease helps ensure accurate pick-up dates captured and reflected on Medicare Part B/DME claims

Automated date corrections help eliminate disruptions to your workflow

Help recover substantial revenue using our MedRx Recovery Medicare specialists to initiate documentation requests, appeal denied claims and manage denials through the final determination

Gain insights from quarterly and annual reports on billing issues, documentation compliance and Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies challenges (DMEPOS) 

Use this information to train staff to help ensure future Medicare compliance and to help reduce denials

Outsource labor-intensive physician outreach for audits

Our audit action specialists manage the entire audit process, including documentation from pharmacy and corporate staff and contacting physicians for medical records