Pharmacy Claim Processing & Reconciliation

Leaders in Pharmacy Claim Processing, RX Switch Services, Billing Technology, Prescription Claim Payment & Reconciliation, Revenue Cycle & Reconciliation Consulting...

Pharmacy Claim Processing & Reconciliation Booth #7307
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Request More Information Visit the Inmar Website


Maximize Your Pharmacy Cash Flow

  • Recover money faster
  • Improve Cash Flow and Profitability
  • Save Time and Effort

Far too many unpaid claims go unaddressed and the money is too often never seen by the pharmacy because there just isn’t time or resources to chase them all down, sort them out and get the money you’re owed for the prescriptions you’ve filled.

Inmar makes it possible. Our Pharmacy Financial Management and Contract Management clients use innovative technology to address underpayment and make a direct impact to profitability.

Pharmacy Financial Management

Rx Reconciliation

Inmar is the largest provider of third-party pharmacy reconciliation in the United States, serving more than 20,000 pharmacies. Inmar’s web-based technology helps you navigate the complexities of the claims and payment reconciliation process, enabling you to focus on exceptions and quickly identify opportunities for collections or operational improvement, which may result in increased revenue and profitability, reduced bad debt and risk, and lower resource burden.

Our tools provide:

  • Comprehensive accounting solution to record pharmacy receivables, post payments and perform cash applications and GL entries.
  • 100% claim-level reconciliation.
  • Dashboards to help you focus on weekly trends, carrier trends and exception management.
  • Experienced account management team provides comprehensive training and unmatched ongoing support.

Inmar’s reconciliation solution delivers value for our clients in the following ways:

  • Reduced Write-Offs
  • Reduced Claim Exceptions
  • Reduced Aging Claims balance
  • Increased Electronic Remittance
  • Improved DSO
  • Improved Service Fee visibility

Contract Management

Without the right knowledge and tools, pharmacies cannot negotiate better rates to increase profitability. Through accurate understanding of brand and generic effective rates, as well as exceptions to the negotiated contract reimbursement rates, and in combination with industry bench marking and competitive analysis, Inmar's patented technology arms you with data insights you need to request rate adjustments and measure the financial impact of contract changes.

Inmar’s Contract Management Program addresses 4 important needs:

  • MAC and GER rate management – are you getting what you should be on generic reimbursement? How do you know?
  • Brand and BER rate management – are you addressing contract violations? Do you have an accurate claims-to-contract matching solution driving your analytics?
  • Price optimization and preferred drug analysis – are you being strategic about your U&C and your preferred drug selections?
  • Purchasing optimization and profitability shifts due to acquisition cost changes – are you using reimbursement data to improve your purchasing?

We continue to invest in the technology to deliver financial analyses on the impact of pharmacy quality and adherence measures to support the movement to value-based healthcare reimbursement.

INMAR, reconciliation, cash flow, claims, third party pharmacy reconciliation, pharmaceutical contract management,

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Pharmacy Claim Processing & Reconciliation Booth #7308
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Request More Information Visit the Net-Rx Website

Net-Rx Is Your Pharmacy's Source for Business Intelligence and Financial Analytics

Net-Rx, an MHA Solution, has specialized in providing operational and technology-driven services exclusively for pharmacies for more than 10 years. Led by industry-recognized experts, we provide a platform for advanced business analytics that drives operational excellence and optimum financial performance across reconciliation, reimbursement verification, and prescription pricing.

As a market leader in pharmacy solutions, Net-Rx has deep industry expertise and is a trusted partner to many of the most recognizable pharmacies in the country. These pharmacies have come to rely on Net-Rx for superior support, actionable insights, and proven results. Net-Rx is committed to exceeding the expectations of our customers, partners, and associates.

Here's how we help Community Retail Pharmacies, Long Term Care Pharmacies, and Retail Chain Pharmacies achieve optimum performance:

  • EditRx -Protect revenues by detecting billing and database errors
  • Metric-Rx™ - Optimize pharmacy operations through actionable business analytics
  • Price-It Rx - Improve profitability with customized market-driven pricing
  • RecRx - Ensure accurate third-party reimbursement
  • Reimbursement Suite - Maximize the combined value of EditRx, Metric-Rx and RecRx
  • Contract Assure – Recover missing revenue by assuring accurate payments on MHA contracted rates.

The recognized leader in pharmacy reimbursement and business analytic solutions!





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Pharmacy Claim Processing & Reconciliation Booth #7310
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Request More Information Visit the FDS Inc Website

FDS Inc

FDS, Inc. is a longtime provider of value added services to the healthcare industry in the form of competitive switching services, online claim reviews, electronic Durable Medical Equipment (DME) claims processing, market share administration, reconciliations services and pharmacy profitability management. We are a leader in pharmacy data warehousing and other data services that help our clients maximize their profitability.

Our Emerging Technology team is focused on bringing new solutions to the changing healthcare marketplace.

eConcile

Comprehensive and Cost-Effective Claims Reconciliation
FDS eConcile® is a cost-effective way to assist pharmacy staff in managing third-party receivables and monitoring third-party payments on prescription and DME claims. Perform reconciliation like you have always wanted to but never had the time or manpower. There is no software to install or maintain.

How eConcile Works

  • FDS automatically collects your electronic remittance advice (835 files) to load into the eConcile engine.
  • Any paper remittances received will be uploaded by FDS.
  • All third-party payments received are posted into eConcile.
  • FDS matches the posted payments to the prescription claims and highlights discrepancies once the claim is reconciled.
  • Management reports are provided for review.

For more information please contact us at info@fdsrx.com or call (877) 602-4179.

FDS, econcile, claims reconciliation, DME claims,



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Pharmacy Claim Processing & Reconciliation Booth #7300
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Request More Information Visit the eRx Network Website

eRx Network

A leading provider of electronic solutions to the pharmacy industry, eRx Network provides comprehensive and innovative services for claims management and analysis, electronic prescribing and specialized processing, such as Medicare/Medicaid DME billing. Our expansive offerings provide pharmacy customers with the tools needed to become more competitive, improve patient care and combat inefficiencies and errors that lead to low reimbursement rates.

Claims Management & Analysis Solutions
eRx Network Connect™ claims switching service provides full access to all third-party processors in the United States via a high-speed, next-generation network. Exclusive online tools like ScriptView™ make real-time claim research and processor troubleshooting easier.

eRx Network Edit™ is an advanced, real-time edit engine designed to increase your pharmacy’s overall profitability by reducing submission errors and optimizing third-party reimbursements. A series of pre/post edits is automatically performed, providing financial, administrative and legal compliance reviews on prescriptions prior to being sent to and received from the processor.

eRx Network CardFinder™ is an industry-leading, real-time eligibility service that can help your pharmacy save valuable personnel time and, as a result, provide enhanced customer service. A single transaction quickly returns commercial coverage information for more than 220 million covered lives and Medicare Part D coverage information for patients 65 years of age or older.

eRx Network Payer Compliance™ resubmission service is designed to maximize third-party claim reimbursements by helping your pharmacy easily identify, reverse and resubmit claims that have been paid based upon outdated average wholesale pricing (AWP). This automated solution is a value-added service available to customers who utilize eRx Network Connect or Edit.

Through eRx Network’s pharmaceutical brand programs, pharmaceutical manufacturers are able to target patient persistency and compliance by delivering to pharmacies real-time, point-of-sale messaging and electronic co-pay offset vouchers. Our revenue-generating programs include eRx Network Voucher on Demand,™ eRx Network Inform,™ eRx Network Redeem™ and eRx Network Print-to-Pharmacy.™

Change Healthcare pharmacy services, erx network and Change Healthcare on Third Party Claim Management Receivables Reconciliation Prescription Remittance Insurance Claim Reimbursement Services. third-party claims management analysis services specialty processing services, and electronic prescribing services with retail pharmacy. Change Healthcare Medicare DME, Change Healthcare Recovery, Change Healthcare Adjudicate, Change Healthcare’s eRx Network® ePrescribing, Change Healthcare Reconciliation Elite, electronic prescribing on third party claims processing.
Emdeon Third Party Claims Processing
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Emdeon
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Inmar

Full Range of Industry-Leading Solutions

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Metric-Rx, Find New Ways to Optimize Profitability and Utilization

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NEW prescription opportunities

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We reconcile and recover down to the penny

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What's keeping you up at night? Our clients sleep better.

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CPCSI

Currently billing third-party payers for compounds? New to third-party billing because you realize that you have missed something? Currently in violation of your third-party contract because you are charging cash for your covered customers? CPCSI Consulting consists of Pharmacists and former PBM Auditors that work together to teach your pharmacy to properly bill third parties for compounded prescriptions.

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ReconRx

ReconRxs Third Party Claim Reconciliation Program actively goes after your money due from third party payers 15 days before competing programs in order to recover missing payments, ensure timeliness of payment and increase cash flow. To learn more about ReconRx and their Third Party Claim Reconciliation program visit Recon-Rx.com today.

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AutoRx

AutoRx offers an online claims system that enables pharmacies to process prescriptions related to auto accidents. In states with No-fault, PIP, and Med Pay insurance laws, prescriptions related to auto accidents can be covered by the patient's auto insurance. AutoRx provides a valuable service that assists both pharmacies and their customers.

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CPCSI

DO IT RIGHT! If you bill third parties, its a fact, you will be audited. As a CPCSI member, our consultants will provide you and your staff the guidance needed to properly follow the PBM contracts, manuals and updates. Our consultants also assist with audit reviews, responses and disputes with PBMs. CPCSI will give your pharmacy the competitive advantage of successfully billing third-parties correctly. Call us today to learn more about CPCSI and how Freedom is more than your supplier.

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Turn information into actionable insights. With connectivity to 90% of all pharmacies, more than 1,000 payers, and partnerships throughout healthcare, you can trust one company to deliver the most comprehensive pharmacy solutions available.

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