Hospital Outpatient Pharmacies

Automating AWP resubmission gave us back dollars we didn't know we were missing and freed our team from manual rework.

Pharmacy Director, Health System

Measurable impact across your outpatient pharmacy operations
Integrated, automated pharmacy tools help teams capture the full value of their operations — from faster therapy starts and reduced audit risk, to supporting operational efficiency and identifying unrecovered reimbursements.
Real-time adjudication data
Claim‑level intelligence delivered in workflow to submit cleaner claims, prevent claim-error denials, and support reimbursement.
Automatic copay support
Help patients start and stay on therapy with copay resources designed to reduce affordability barriers at the pharmacy.
Average Wholesale Price resubmission
Recover potential lost dollars from outdated pricing data through automated AWP resubmission reporting.
Drug Enforcement Administration validation
Prescriber DEA credentials validated on controlled‑substance claims and checked daily against federal DEA file.

Solutions built for outpatient pharmacy complexity

Outpatient and health system pharmacies face rising complexity across access, affordability, compliance and reimbursement. Explore the integrated capabilities that help teams manage high-touch therapies, navigate payer requirements and maintain operational efficiency.

Real-time visibility and workflow integration across your health system pharmacy workflow

Gain real-time adjudication data visibility across the specialty journey to manage complex therapies with greater precision. Embed technology directly into existing workflows to minimize friction and avoid operational disruption. Support coordinated care across inpatient and outpatient settings, enabling pharmacies to serve as central hubs for high-touch therapies.

Automated workflows for access, claims and affordability

Automate access, claims, and affordability workflows to reduce manual workload and accelerate therapy starts. Apply automatic copay savings to eligible claims to reduce patient costs and help improve adherence. Initiate prior authorizations directly from the claim to streamline processes and reduce therapy delays.

Promote revenue and support financial performance

Recover any lost dollars from outdated pricing data through AWP resubmission reporting. Convert eligible denied claims into paid claims to reduce revenue leakage and improve patient retention. Use real-time rules engines to validate claims, capture revenue and reduce rework.

Reduce audit risk and support compliance

Monitor for common audit triggers—such as plan limitations, quantity issues, or incorrect days' supply — before submission. Validate prescriber DEA credentials and screen for excluded prescribers to reduce compliance exposure. Surface critical payer message codes and required next steps to help prevent missed actions. Automate vaccine validation and deliver real-time safety alerts to support regulatory accuracy and patient safety.

Advance patient safety and clinical quality at dispense

Help identify potential dispensing errors, including look-alike/ sound-alike risks, in real time. Provide clinical and consumer safety notifications at the point of dispense. Strengthen adherence and continuity of care through proactive, automated interventions.

Real-time visibility and workflow integration across your health system pharmacy workflow

Gain real-time adjudication data visibility across the specialty journey to manage complex therapies with greater precision. Embed technology directly into existing workflows to minimize friction and avoid operational disruption. Support coordinated care across inpatient and outpatient settings, enabling pharmacies to serve as central hubs for high-touch therapies.

Automated workflows for access, claims and affordability

Automate access, claims, and affordability workflows to reduce manual workload and accelerate therapy starts. Apply automatic copay savings to eligible claims to reduce patient costs and help improve adherence. Initiate prior authorizations directly from the claim to streamline processes and reduce therapy delays.

Promote revenue and support financial performance

Recover any lost dollars from outdated pricing data through AWP resubmission reporting. Convert eligible denied claims into paid claims to reduce revenue leakage and improve patient retention. Use real-time rules engines to validate claims, capture revenue and reduce rework.

Reduce audit risk and support compliance

Monitor for common audit triggers—such as plan limitations, quantity issues, or incorrect days' supply — before submission. Validate prescriber DEA credentials and screen for excluded prescribers to reduce compliance exposure. Surface critical payer message codes and required next steps to help prevent missed actions. Automate vaccine validation and deliver real-time safety alerts to support regulatory accuracy and patient safety.

Advance patient safety and clinical quality at dispense

Help identify potential dispensing errors, including look-alike/ sound-alike risks, in real time. Provide clinical and consumer safety notifications at the point of dispense. Strengthen adherence and continuity of care through proactive, automated interventions.

Custom solutions built for outpatient pharmacy complexity

Outpatient and health system pharmacies face rising complexity across access, affordability, compliance and reimbursement. Explore the integrated capabilities that help teams manage high touch therapies, navigate payer requirements and maintain operational efficiency. We contract with you directly to tailor health system-specific solutions.

Delivering impact for outpatient pharmacies

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The impact of our network speaks for itself. Together, our work helps improve time to therapy, breaks through medication affordability obstacles and promotes greater connectivity among care teams to achieve better health outcomes.