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MedRx Network

MEDICAL CLAIMS BILLING FOR THE PHARMACY
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Improve efficiency and get paid quickly and accurately.

The MedRx Network offers a flexible platform for pharmacy billing commercial, Medicare and Medicaid claims such as durable medical equipment (DME), immunizations, and more. Extensive editing capabilities with clear messaging provide the tools for the pharmacy to easily correct claims to get paid quickly and accurately. Our denial management services work underpaid and denied claims through to final determination. In addition, the MedRx Network features a customizable solution that reduces the risk of audits and encourages patient adherence and compliance.
  • Recovery

    The MedRx Network Recovery Solution is a comprehensive compliance and denial management service designed to help your pharmacy recover revenue by solving back-end Medicare and Medicaid Part B DME claims management issues. Upon enrolling, your pharmacy will be assigned a dedicated Medicare/Medicaid recovery specialist who will proactively work underpaid and denied claims through to final determination.

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  • CrossCheck

    Lost revenue and administrative hassles are often the results when pharmacies indicate inaccurate Medigap coverage on Medicare Part B claims. As part of the MedRx Network, CrossCheck is designed to identify in real-time patients’ most recent supplemental coverage information at the point of care.

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  • Medicare Flu

    The Change Healthcare MedRx Network Flu Solution enables your pharmacy to bill flu and pneumonia vaccinations electronically at point of fill, using your existing pharmacy management system. Claims are subjected to numerous policy, format, and eligibility-based edits before being accepted into the Change Healthcare system. From there, claims are forwarded to the appropriate local Part B carrier for adjudication and payments are delivered directly to the pharmacy.

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  • Audit Action

    Audit Action is a customizable, complete solution that enables pharmacies to remain compliant with Medicare Part B/DME billing requirements. Customers can choose the mix of solutions that best meets their needs to improve audit success rates as well as encourage compliance.

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