Commercial MedRx

A claims billing solution for pharmacies that want to submit claims electronically to major commercial medical insurance payers and plans in NCPDP format using the existing pharmacy management system.

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Submit Commercial Claims

submit claims electronically

Easily submit claims electronically to major commercial medical insurance payers and plans in NCPDP format.

dispense commercial medical claims

Dispense commercial medical claims within your standard pharmacy workflow. No additional hardware or software needed. 

seamlessly integrate commercial claims billing solution

Seamlessly integrate our commercial claims billing solution with your existing pharmacy management system.

eliminate labor paper billing

Eliminate labor-intensive paper billing processes and manual entry web-based services with this efficient alternative.

determine eligibility in real time

Determine eligibility in real-time at the point-of-sale for more accurate payment collection. Returns eligibility and co-pay information in real-time.

gain payer visibility

Gain visibility into other payers available in your geographic region, and work with our enrollment team to get and stay enrolled in more plans. 

Streamline Billing with Electronic Submissions

electronic billing technology

Electronic Billing Technology

  • Submit claims electronically to major commercial medical insurance payers and plans in NCPDP format using your existing pharmacy management system.
  • With this specialized processing solution, claims are subjected in real-time to eligibility and plan formulary based edits before being accepted into the Change Healthcare system.
  • Claims are then forwarded to the appropriate payers for adjudication, and payments are delivered directly to your pharmacy.
integrated claims filing process

Integrated Claims Filing Process

  • Provides easy electronic access to major commercial medical payers and plans, which can help your pharmacy simplify the claims submission process when billing commercial payers.
  • Enables your pharmacy to dispense commercial medical claims within your standard pharmacy workflow, and directly integrates with existing pharmacy management systems. No additional hardware or software needed.
real-time claim edits

Real-Time Edits

  • Get more accurate payment collection at the point-of-sale with covered commercial medical claims for immunizations that are subject to real-time edits.
  • Ensures up front editing is in line with our retail partners’ payer contract and requirements. Includes formulary load to ensure NCPDP pricing response matches payment expectations.
  • Get real-time access the payer’s eligibility data to reduce coverage denials.

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