MedRx Medicare & Medicaid Immunizations

Electronic claims submission for pharmacies that want to streamline Medicare Part B flu and pneumonia immunizations billing, increase revenue, and provide convenient alternatives to patient care.

Increase Your Payment Rate

Improve reimbursement with real-time eligibility edits that check a patient’s Part B coverage for the administered vaccination.

Enhance transparency with web services that provide additional visibility into your claim status, helping to streamline reconciliation.

Easily verify beneficiary information, including active Medicare Part B coverage and existence of other primary insurance or managed health plans.

Save time and improve staff efficiencies by partnering with a customer support team available to assist with EDI paperwork and other enrollment issues.

Simplify existing workflow by automating administration fee calculation, NDC to HCPCS mapping, ICD-10 submission and pharmacy-to-Medicare billing unit conversion.

Streamline your claim filing process with the ability to verify patient eligibility directly from your existing pharmacy practice management system.

Streamline Your Immunization Billing

Automated coverage verification

  • Check a patient’s Part B coverage for the administered vaccination using real-time eligibility edits, which verify beneficiary information, such as name, gender, date of birth, Medicare ID number, and more.
  • Verify information such as active Medicare Part B coverage, beneficiary not covered by hospice or in a Medicare Part A hospital stay, and existence of other primary insurance or managed healthcare plans.

Simplified claim filing process

  • Implement the filing of Medicare Part B vaccination claims as part of your standard pharmacy workflow. Our immunizations solution uses your existing pharmacy system and simplifies the claim filing process.
  • Automate administration fee calculation, NDC to HCPCS mapping, ICD-10 submission and pharmacy-to-Medicare billing unit conversion. Customers frequently achieve over 99% payment rates.

Web services

  • Gain added visibility into your claim status. You can view status and payment information, view and print Medicare remittance, and download the raw 835 to your reconciliation system.

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