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can help your pharmacy recover lost dollars on third-party transactions where the AWP has increased on claims paid with outdated information.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    Automatically tracks AWP updates and flags claims paid using outdated pricing.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.

Join CoverMyMeds’
ever-growing network.

  • 950,000+ providers, with 350+ EHRs integrated
  • 50,000+ pharmacies, inclusive of top 10 chains
  • 650+ brands across 95% of therapeutic areas Connect with our team to see how CoverMyMeds can help deliver comprehensive solutions to improve patient access, affordability and adherence.
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