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Guaranteed Rebilling ServiceBack to PioneerRx Pharmacy Software
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Third parties base a pharmacy’s contracts upon some form of manufacturer’s price. When a manufacturer increases their price, many third parties experience a delay in obtaining and entering the new information into their systems.
When this situation occurs, the pharmacy may not receive the correct amount of payment. In order to receive this amount, the claim must be re-billed to the third party within the “window” for claims resubmission. Because some claims may not be reversed, oftentimes pharmacies experience losses when attempting to resubmit the claim.
Guaranteed Rebilling works to address this problem by absorbing the risk of the reversed transaction. Over 80% of the claims that are re-billed under this system result in increased reimbursement to the pharmacy.
With PioneerRx's guaranteed program, there is no risk - it's your money!
PioneerRx handles rebilling with no pharmacy involvement required.
- The sum of losses, new money earned and switch fees are added together to form a “gross” amount based upon monthly performance. (Earnings – Loss – Switching Fees = Gross).
- If the “gross” is negative, the pharmacy is given a credit on their monthly charges.
- If the “gross” is positive, PioneerRx receives 25% for rebilling the claims and absorbing the rebilling risk.
- A real time report is available on-line and the pharmacy receives a monthly detail of the billing activity.
PioneerRx and Guaranteed Rebilling would be a great addition to your pharmacy.
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Back to PioneerRx Pharmacy Software
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