Streamlined Processing

MedRx automates many of the manual processes currently associated with medical pharmaceutical benefits. More sophisticated management services are added without additional staff or infrastructure by incorporating an automated electronic HIPAA-compliant interface, EDI transactions from providers and health plans, and prompt claim turnaround for final adjudication, as well as:

• Automated NDC-level pricing and editing of medical pharmacy claim transactions
  
  
• NDC & HCPCS cross-walking for claim submissions
  
  
• Automated management of medical pharmacy miscellaneous codes
  
  
• Automated processing of prior authorization transactions within both the medical and pharmacy benefits
  
  
• Easy integration with HIPAA-compliant transaction sets