Pharmacy Claims Processing

PharmaPlus empowers pharmaceutical companies to streamline your pharmacy claims processing, administrative and claims operations into one user-friendly cloud package. Designed to be fully customizable for your business and simplify each claim, our software offers convenient access to the most recent financial and clinical claims support data.

Our framework significantly saves your time and money with round-the-clock accessibility and built-in code error check, as well as the need for pharmacy claims adjudication.

Take a look at our full claims features below!

Our Pharmacy Claims feature set:

  • Electronic eligibility verification and claims capture
  • A safe and reliable claims processing engine that integrates both past and present claims data
  • Flexible rules-based processing to accommodate your way of doing business
  • Maintenance of your claims history file
  • Unlimited plans and tiers for flexible benefit configuration
  • 24/7 system access for authorized users
  • Backup systems for batch processing for providers
  • Claim reversal-and-response processes
  • Ad hoc report production for customers
  • Maintenance of reference files required for claims processing and reporting functions
  • Full EDI capabilities and integration with employers and trading partners
  • Live updates of clinical/financial support data to ensure the highest accuracy for each claim
  • Comprehensive code error check

Features

Pharmacy Claims Processing

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Pharmacy Benefits Configuration

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Network of Pharmacies

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Administration & Maintenance

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