ATLANTA--(BUSINESS WIRE)--RelayHealth Pharmacy Solutions, part of the McKesson Prescription Technology Solutions business, today announced the development of a new pharmacy platform, RelayRx™ Medical Billing, that will enable retail pharmacists to document and bill for clinical services that may be covered under a patient’s medical benefit plan, such as immunizations, diabetes education, point-of-care testing and more.
Over the next decade there will be a shortage of more than 40,000 primary care physicians in the United States.1 So as pharmacists continue to gain “provider status” across the country, they are well positioned to fill that gap by delivering care and receiving reimbursement for a broader range of clinical services in the pharmacy. Today, many pharmacists perform such services, but may have to forgo reimbursement or navigate a highly manual billing process.
RelayRx Medical Billing (RxMB) will leverage the RelayHealth network that more than 50,000 retail pharmacies rely on to help improve their financial performance. RxMB empowers a pharmacist to check eligibility and bill for clinical services by utilizing the X12 billing pathway, the typical billing pathway for physicians and hospitals. With RxMB, pharmacists can submit eligibility checks and claims in workflow. Within workflow, they then can use the clinical documentation platform offered by STRAND Clinical Technologies – or the pharmacy’s existing clinical documentation service – to document the clinical aspects of the encounter required for reimbursement. STRAND will also provide other services related to the intervention and documentation, such as care coordination with other members of the healthcare team.
“Our retail pharmacy partners tell us every day they are eager to play an even more impactful role in improving healthcare across their communities and that they need technology that will allow them to do that,” said Scott Genone, general manager and vice president of RelayHealth Pharmacy Solutions. “RelayRx Medical Billing is the innovative platform that does just that. Patients will have greater access to care services in their local pharmacy, services that may be covered under their medical benefit plan. This improved access to care ensures patients can receive the services they need when they need them most and pharmacies can easily submit reimbursement for services delivered.”
RxMB eliminates the need for retail pharmacies to invest in a separate practice management system that can accommodate the X12 billing transaction. Instead, pharmacy system vendors can simply map to the RxMB protocols and offer their pharmacy customers the additional functionality of submitting the required information for reimbursement. Multiple pharmacy system vendors have already planned efforts to incorporate RxMB into their portfolio.
Similarly, traditional medical claims clearinghouses can benefit from the expanded pool of qualified billing transactions from thousands of retail pharmacies nationwide by connecting into the RxMB platform.
RxMB will help ensure a consistent workflow for enhanced services documentation and billing while maintaining a completely paperless experience.
“As enhanced services opportunities continue to expand, pharmacies will need powerful tools to engage patients within their workflow,” said David Pope, chief of innovation and co-founder of STRAND Clinical Technologies. “Through the RelayHealth partnership, pharmacists will have access to an end-to-end solution that simplifies the number of dashboards they’re using on a daily basis. We’re thrilled to work alongside the team at RelayHealth to improve patient outcomes and provide powerful reimbursement opportunities for clinical encounters.”
To learn more about RelayRx Medical Billing please visit RelayHealth.com/MedicalBilling.
1 2017 AAMC Commissioned Study: The Complexities of Physician Supply and Demand
About STRAND Clinical Technologies
Co-founded by a community pharmacist and a technology expert in 2008, STRAND Clinical Technologies is the U.S. market leader in helping pharmacists launch clinical services within their community. They support community pharmacists across the country in engaging patients with chronic disease, such as diabetes, through STRAND, a wide-reaching intervention, documentation, and education platform capable of developing the new Pharmacist eCare plan. Their mission is to transform the community pharmacy marketplace by inspiring and empowering pharmacists to engage clinical pharmacy practice in improving both the health of their business and the health of their patients. For more information, please visit: http://www.strandrx.com.
About RelayHealth Pharmacy Solutions
RelayHealth Pharmacy Solutions (RHPS), part of McKesson Prescription Technology Solutions, manages the nation's leading pharmacy network, providing essential healthcare connectivity among retail pharmacies, physicians, health plans, pharmacy benefit managers, government agencies and pharmaceutical manufacturers. Processing more than 18 billion healthcare transactions annually we deliver prescription benefit transparency to physician EHRs and help more than 50,000 retail pharmacies streamline operational efficiency, improve medication accessibility and adherence and deliver value-added, cost effective clinical services that improve patient health and outcomes. For more information, visit http://www.relayhealth.com/RHPS.
