Services Directory: Reconciliation Services
Third Party Station (Pharmacy First)
Offers management of third-party payer contracts and reconciliation. It provides claim-level reconciliation to ensure pharmacies receive the paid-claims response amount. In the case of a discrepancy, it automatically contacts the payer on the pharmacy’s behalf to ensure accurate compensation.
For more information, or to enroll, visit www.pharmacyfirst.com.
Offers a full range of programs and services through a buying group of more than 1,000 independently owned pharmacies across the country. Reconciliation programs are available through QS/1’s Data Collection service to member pharmacies that enroll.
For more information, or to enroll, visit www.epicrx.com.
Offers services to help QS/1 Customers grow their businesses and provide quality care to long-term care patients. It provides a group purchasing organization (GPO) that offers unique contracts and pharmacy services to long-term care and closed-door pharmacies across the country and reconciliation programs through QS/1’s Data Collection service to member pharmacies that enroll.
For more information, or to enroll, visit www.gerimedgso.com.
Provides pharmacies and health systems of all sizes with applications that include claim reconciliation, exception management and patent-pending technology for managing contracts and business intelligence. It manages claims and provides payment reconciliation services for pharmacies to ensure appropriate reimbursements.
For more information, or to enroll, visit www.inmar.com.
A web-based service that positively transforms the way pharmacies manage their claim and payment data. ProviderPay automates and accelerates many of the tasks required to manage the financial side of the pharmacy, such as reconciling claims to remittances, connecting to and managing electronic payers, and compiling key information for pharmacy actions.
For more information, or to enroll, visit www.providerpay.net.
Provides a reconciliation service, RecRx, which easily integrates with QS/1’s systems and enables pharmacies to receive payments directly from a third party with remittance advice going to RecRx in an 835 file format. The file is available as a detailed claim-adjudication summary on a secure website, and the pharmacy can download the actual 835 file to use it for auto-posting.
For more information, visit www.mhainc.com.
Independent Assist by National Health Information Network (NHIN)
Provides third-party file maintenance to assist pharmacies with filling, submitting and receiving reimbursements for third-party prescriptions against the latest edits available.
For more information, or to enroll, visit www.nhin.com.
ReconRx by Pharm Assess, Inc.
Provides reconciliation and tracking of third-party reimbursements through the ReconRx program. It provides an efficient and cost effective way to track and recover payments and tracks payments at the transaction-level to ensure payment in the amount promised at the time of adjudication.
For more information, or to enroll, visit www.recon-rx.com.
Pharmacy Providers of Oklahoma, Inc. (PPOK)
Provides a third-party prescription management program with automated reconciliation of third-party claims at the transaction level. It offers an accounts receivable reporting tool, Check Register, to bridge the gap between 835 check dates and actual received-on dates.
For more information, or to enroll, visit www.ppok.com.