3rd Party Claims Management, Prescription Insurance Claim Processing, Third Party Medical Claim Reconciliation











 Inmar
Booth #7307


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,

 Net-Rx
Booth #7308

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!

 AutoRx, A Mitchell Pharmacy Solution
Booth #7303
AutoRx, A Mitchell Pharmacy Solution


What we do

We allow pharmacies to process prescriptions related to auto accident injuries and get guaranteed payment. With over 4 million prescriptions processed, AutoRx is the largest and most advanced processor of auto related pharmacy transactions in the US.

We make it easy for patients injured in auto accidents to fill their related prescriptions at a pharmacy of their choice. AutoRx enables pharmacies to electronically process and bill No-Fault / PIP auto claim prescriptions - eliminating the need for patients to pay cash and submit receipts*. By contracting with over 47,000 pharmacies and working with all major auto insurance companies, we are able to ensure that qualified prescriptions get dispensed and billed, properly and immediately.


Who we serve

We serve you – If your have patients with auto accident related prescriptions, AutoRx can help you.

If your patients have been injured in an auto accident and have first party medical benefits (No-Fault, MedPay, or PIP auto policy), prescriptions and DME related to the accident may be covered by their auto insurance. We allow you to process these scripts and be guaranteed payment on valid claims.


How We Do It

By utilizing electronic connectivity with our pharmacy network and auto insurance partners, AutoRx is able to increase efficiencies in the processing and dispensing of auto claim prescriptions.

Pharmacies - Too Many Unknowns With Auto Prescription Claims?

Over 2.3 million persons are injured every year in auto accidents - one every 13 seconds. Many of those injured are eligible for medical benefits under their No-Fault/PIP auto insurance. However, many questions that must be answered before you can process a claim. Questions such as:

  • Whom do I bill and where do I send it?
  • Is the medication related to the accident?
  • Does the patient have benefits available?
  • Will I get paid, and when?


AutoRx Has the Answers

  • Immediate adjudication for most claims
  • 15 min. verification response (if needed)
  • Guaranteed payment on all processed claims
  • No out-of-pocket costs incurred by patient*
  • Qualified support by in-house Help Desk
  • AutoRx accepts all major auto insurers

*depending on state insurance laws and individual policy limits

car accident Prescription pick up Road Side Prescription Claims
autorx, claims processing, electronic processing, auto accident, prescription claims, DME, auto insurance claims, Mitchell Pharmacy Solution

 Emdeon
Booth #7300
Emdeon

Emdeon Pharmacy Services

A leading provider of electronic solutions to the pharmacy industry, Emdeon 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.

Electronic Prescribing

Emdeon’s eRx Network ePrescribing enables the direct exchange of ePrescribing transactions between pharmacies and physicians through their ePrescribing application. By automating new prescriptions and refill requests/ responses, eRx Network ePrescribing improves the prescription process’ overall efficiency and, as a result, the quality of patient care. Utilizing its Intelligent Routing™ to determine the most efficient electronic route between pharmacy and physician, eRx Network is able to provide a single route for all refill requests (fax or electronic), regardless of the prescriber’s participation in ePrescribing.

eRx Network ePrescribing is further set apart by a variety of value-added, online self-help and troubleshooting tools. Our real-time script-viewing application allows pharmacy users to view all transmitted refill requests and new prescriptions.

Contact an Emdeon sales representative to find out which services are available for certain commercial payers.

Claims Management & Analysis Solutions

Emdeon 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 Emdeon ScriptView™ make real-time claim research and processor troubleshooting easier.

Emdeon 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.

Emdeon 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.

Emdeon offers two solutions to monitor and track payments of third-party prescriptions. Emdeon Reconciliation Elite™ and Emdeon Reconciliation Essential™ easily balance sales and remittance with check information, reporting discrepancies via a user-friendly web interface. Elite includes pursuit of outstanding unpaid claims.

Emdeon 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 Emdeon Connect or Emdeon Edit.

Through Emdeon’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 Emdeon Voucher on Demand,™ Emdeon Inform,™ Emdeon Redeem™ and Emdeon Print-to-Pharmacy.™

Pharmacy Claims & Reconciliation Emdeon Third Party Claims Processing Emdeon Claims Processing Emdeon Innovative Solutions for Pharmacy Emdeon Third Party Claims Management Emdeon
emdeon pharmacy services, erx network and Emdeon 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. Emdeon Medicare DME, Emdeon Recovery, Emdeon Adjudicate, Emdeon’s eRx Network® ePrescribing, Emdeon Reconciliation Elite, electronic prescribing on third party claims processing.

 CPCSI: A Division of Freedom Pharmaceuticals
Booth #7301
CPCSI: A Division of Freedom Pharmaceuticals

CPCSI Consulting is a nationwide consulting firm dedicated to the specialized practice of pharmacy compounding. Our professionals include highly skilled doctors of pharmacy trained in the area of compounding as well as in-house attorneys who have committed their practice to defending the rights of independent compounding pharmacies by educating pharmacy owners of their rights and responsibilities when billing third-parties. Together, our team of professionals is prepared to educate, guide and assist you and your pharmacy with any issue or obstacle that may arise when billing third-parties.

Education & Membership Services

Education

Third-Party Billing & Audit Response Education: Our team of professionals has over 25 years of experience and success in properly billing third-party entities for sterile and non-sterile compounds. Let CPCSI Consulting work with you and your pharmacy in acquiring third-party contracts; reviewing and understanding the terms of third-party contracts and manuals as they relate to compounded pharmaceuticals; how to properly bill third-parties within the meaning and terms of the contracts and manuals; and, the proper methods of responding to third-party audits. Even if your pharmacy currently bills third-party entities, let us ensure that your methods are up-to-date and accurate according to the terms of the most recent third-party contracts.

Membership Services

Direct Audit Response Assistance: If you bill third-party entities, you will get audited. Members of CPCSI receive unlimited assistance and guidance on properly responding to third-party audits. As a CPCSI member, you can be assured that your audit response will be justifiably accurate to help prevent third-parties from recouping or withholding your hard earned money. But remember, if you fail to bill properly, your success during an audit diminishes greatly. Become a member of CPCSI and let our professionals guide you through this stressful and sometimes convoluted process to ensure a successful outcome for you and your pharmacy.

Third-Party Contract Review: At CPCSI Consulting, our team has extensive knowledge and experience in working with third-party entities and their contracts. As a CPCSI member, our doctors of pharmacy and attorneys can work with you and your pharmacy to demystify the language and meaning of a third-party contract and help you understand your rights and obligations when working within the terms of the contracts. The professionals at CPCSI will help point out potential pitfalls and potential negotiating points of individual third-party contracts.

Contract Library Database: CPCSI members have access to our extensive Contract Library Database, which allows our clients to get answers to specific questions about contracts our members are currently a party to or contracts our members wish to join. This access allows our members to make educated decisions about which third-parties are right for their pharmacy.

Third-Party Contact Points: Members of CPCSI will have access to our vast database of third-party contacts, including the names, phone numbers, and addresses of key third-party personnel who can assist you and your pharmacy in resolving third-party billing issues.

Litigation Consulting: If you and your pharmacy have conformed to the terms of the contract, billed properly and accurately and adequately responded to an audit request only to have a significant portion of that billing recouped or withheld, talk to CPCSI. Members of CPCSI have unlimited access to CPCSI’s attorneys who can help you identify your options, weigh your alternatives, and discuss how you should move forward.

Legal Referral Services: CPCSI members have access to our network of attorney contacts located throughout the United States giving you an immediate advantage if you choose to pursue legal action. We have worked hand in hand with attorneys in all parts of the country who have significant experience in defending independent pharmacies who choose to fight back. Let CPCSI be your starting point to a successful outcome.

For more information about CPCSI or to contact us, use the link provided below.

CPCSI: A Division of Freedom Pharmaceuticals CPCSI Consulting CPCSI Claims Processing CPCSI Pharmacy Compounding CPCSI
CPCSI: A Division of Freedom Pharmaceuticals on Claims Processing and CPCSI Consulting, nationwide consulting firm and practice of pharmacy compounding with Third-Party Billing & Audit Response Education. Direct Audit Response Assistance, Third-Party Contract Review, Contract Library Database, Third-Party Contact Points, Litigation Consulting and Legal Referral Services.

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