MedRx Network

A medical claims billing and consumer engagement solution for pharmacies that want to recover revenue, get paid faster, quickly correct denials, improve overall workflow efficiency, simplify compliance, and better engage with patients at the point of care.

MedRx Overview

MedRx is a dynamic platform for billing medical claims, such as durable medical equipment (DME) and immunizations, directly from the pharmacy management system. Extensive editing capabilities, a breadth of payer connectivity, and clear messaging provide the tools for pharmacy staff to easily determine eligibility, bill and correct claims, ultimately improving efficiency and payment rates.

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Medical Claims Billing for Pharmacies

Our versatile and powerful editing platform allows pharmacies to improve billing efficiency and maximize reimbursement. Pharmacies can bill commercial, Medicare, and Medicaid claims directly from the pharmacy management system.

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MedRx Medicare & Medicaid DME

A solution for pharmacies that want to determine eligibility for Medicare and Medicaid DME, reduce denials, maximize reimbursement, and submit claims electronically through existing pharmacy management systems.

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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.

Learn More about MedRx Medicare & Medicaid Immunizations

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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Value-Add Medicare Part B DME Services

The Change Healthcare MedRx Network offers value-add solutions to increase Medicare Part B payment rates up to 99%. Select from flexible offerings to remain compliant with Medicare Part B/DME requirements, improve your audit and recovery success rates, better determine consumer payment responsibilities, and submit accurate claims the first time.

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MedRx Recovery

A comprehensive compliance and denial management service for pharmacies that want to improve Medicare Part B DME claims billing and recover significant revenue faster.

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Audit Action

A complete solution for pharmacies that want to improve audit success rates, drive revenue, and remain compliant with Medicare Part B DME billing requirements.

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CrossCheck

A solution for pharmacies that want integration of Medicare supplemental information and a more accurate patient collection process at the point-of-care.

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Release File

A solution for pharmacies that want to reduce denials by automating service-date alignment with claims processing.

Learn More about Release File
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Smart Messaging

Smart Messaging is a custom messaging solution for retail pharmacies, payers, pharmaceutical companies, and providers that want to leverage the Change Healthcare MedRx Network to better reach consumers at the point of care. Based on available eligibility information from insurance plans, Smart Messaging delivers targeted messages to the pharmacy management system for direct communication with the consumer. Smart Messaging allows pharmacists to receive customer messages without leaving their workflow. 

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Pharmaceutical Messaging

A custom messaging solution for pharmaceutical companies that want to leverage the MedRx Network to capture higher immunization rates and drive consumer engagement at the point-of care.

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Providing Measurable Value

  • 30,000+

    pharmacies enrolled

  • 92%

    average audit success rate

  • 99%

    Medicare payment rate

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