Managed Care Contracting

Set your pharmacy business on a sound footing. Reap benefits from our long-standing relationships with regional and national health plans as well as payers. Designed to enhance and sustain dispensing revenue, our managed care contracting program offers multiple chain codes for access to those contracts that are best suited to your needs.

Direct Contract Consulting

Line up emerging opportunities with your strategic goals. Explore both traditional and non-traditional service contracts with expert advice. Our contract review process comprises intelligent data analysis and projection, evaluation of current to proposed rates, and breakdown of COG and overhead costs. Recommendations that arise from the review process include what would be an acceptable counter offer based on a thorough analysis of contract rates.

The Quality Center

Maximize your ROI from patient interactions and meet performance goals. Access a personalized, web-based toolkit for actionable insight into patient behavioral patterns. Key features include a user-friendly dashboard, MTM dashboard, and single sign-on access to EQuIPP®.

Compliance GUARDIAN

Build a culture of compliance and preserve patient access. Maintain in-network status with a customized web-based solution that offers training modules on HIPAA Security and FWA; OIG and GSA exclusion verification; and attestation support. Having quick and easy access to important documentation that shows proof of compliance in the event of an audit can help you avoid penalties.

ClaimGUARD

Maximize reimbursement. Reduce your administrative burden with a solution for the research, analysis, and submission of generic MAC claims reimbursed below cost. Key features include automated processes driven by claims data and wholesaler invoice cost tables; flagging of discrepancies between claims payment and invoice cost; and monthly follow-up on your behalf with PBMs to improve response rates.

Central Pay

Maintain a steady stream of cash flow. Conveniently aggregate payments and boost your cash flow with a centralized program for efficient reimbursement. Our differentiated program operates on a same-day payment policy so that all funds received from a payer on a given day are disbursed on that same day, ensuring that you have sufficient cash on hand.

True Script Reporter

Save time with custom reporting on reimbursement data. Keep track of aggregate payments as well as your electronic remittance advice (835) files with the help of an easy-to-use, web-based reporting platform. You can adapt and utilize exportable report options to support your financial reporting.