• Specialty Distribution
• PharmaGen
• Emergency Shipment
• GPO Partnerships
• 340B
• Reimbursement Solutions
• Clinical Trial Procurement

Programs & Services: Reimbursement Solutions

We negotiate advantageous contracts and provide premium business solutions, responsive service and timesaving resources, enabling pharmacies to increase profitability and remain focused on quality patient care.

Third Party Network

Our programs enable pharmacies to benefit from streamlined processes and improved profitability. We leverage an experienced team to negotiate competitive contract rates, terms and conditions and to provide reimbursement support. With a customized approach to meeting each facility's unique needs, we empower our 1,000+ members to succeed in the dynamic healthcare industry. 

• Free fraud, waste and abuse training
• Proactive industry communications
• Responsive and knowledgeable Help Desk

Reconciliation

Manage account receivables more simply. Reconciliation is available to all pharmacies and is an industry-recognized program for claims tracking. 

• Electronic verification of payments to ensure correct reimbursement
• Elite chase program to track underpaid and unpaid claims
• Robust reporting tools

Electronic Funds Transfer

With Electronic Funds Transfers (EFT) for over 35 PBMs, we help you reduce lost or delayed checks and receive reimbursements faster.

• Improve cash flow
• Reimbursements for Medicare Part D and a growing list of Commercial plans
• Automatic enrollment in future EFT programs

Medicare and Medicaid Processing

Submit dispensing and supply fees automatically for eligible durable medical equipment through our specialized processing and billing solution.

• Point of sale alerts when U & C pricing is below the Medicare/Medicaid allowable price point
• Achieve accuracy, profitability and decrease bad debt

Flu and Vaccination Billing

Increase pay rates with electronic vaccination claim billing. Our solution enables your pharmacy to submit Medicare Part B flu and pneumonia vaccination claims electronically using your existing pharmacy management system.

Did you know that on average, customers that use our solution benefit from a 98% overall payment rate?

• Increase pay rates and electronic vaccination claims billing
• Simplify the claims filing process through point of sale eligibility
• Real time edits and electronic billing for NDC to HCPCS mapping and fee calculation

Central Pay

This new comprehensive program creates financial efficiencies for independent pharmacies.

• Aggregates daily payments and 835 files into one payment
• Includes all payers that offer 835 files

Rec Lite

View and download your 835 files in Excel or as a PDF via a web portal. 

• Beneficial for pharmacies whose systems do not support 835 files