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> Claims Processing & Network Services Patient Assistance / Replenishment Programs
Claims Processing
Claims are submitted at the pharmacy online at the point-of-sale and are instantly adjudicated using over 500 system edits. To promote safe and cost- effective prescribing, pharmacists receive online messages and warnings before the prescription is dispensed — including drug-drug interaction, refill too soon, and maximum/minimum dosages. NEChealth customizes these warnings to suit your population. If the claim passes these edits, our system determines the copayment, which is paid at the pharmacy.
Account Management
Benefit Design
Claims Payments
Claims Processing
Clinical Services
Drug Utilization Reviews (DUR)
Formulary
Help Desk/Customer Service
Mail Order
Payer of Last Resort
Pharmacy Network
Prescription Cards
Pricing
Rebates
Reporting
       
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