Solutions

Reimbursement services

Simplifying how pharmacies can recover lost dollars and optimize resources — to prioritize important tasks, including patient care.

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The challenge

Prescription drug average wholesale prices (AWP) fluctuate regularly, leaving pharmacies responsible for tracking updates in real time. Missing a change can result in lower reimbursements and tighter margins, requiring staff to divert time and resources from essential tasks at a time when pharmacies are already facing labor shortages.

Reimbursement services benefits

Our services can help your pharmacy recover lost dollars on third-party transactions where the AWP has increased on claims paid with outdated information. After the payer updates pricing data, we send out a report outlining opportunities to recover lost dollars by reviewing, reversing and resubmitting the claim in question.

Reduce manual monitoring
Automatically tracks AWP updates and flags claims paid using outdated pricing.
Streamline pharmacy workflows
Provides online reports and automated resubmission options, simplifying with less disruption.
Recover eligible reimbursements
Identifies opportunities to resubmit claims when payers update drug pricing data.
Improve cash flow
Ensures reimbursements reflect the most current pricing — avoiding lower reimbursements and reduced margins.