Streamline Your Pharmacy’s Claims Process with E-Remittance

Posted on Feb 28, 2023

Outside of dispensing prescriptions, effectively managing claims is another important part of your pharmacy’s workflow. Without the right systems in place, pharmacies can end up spending a lot of time submitting, tracking, and reconciling their claims. That’s why BestRx offers independent pharmacies a way to streamline the entire claims process using electronic files – from the submission through the payment reconciliation.

An electronic claim is a paperless claim that’s generated by the pharmacy’s BestRx software and is transmitted electronically to an insurance or third-party payer to be processed. Once the payer has processed and returned the paid claim, the pharmacy will need to begin the reconciliation process. When done manually, this can be a tedious, time-consuming task. Using e-remittance through BestRx, pharmacies can access their 835 remittance files directly from their software. Storing all third-party files in one place not only makes it easier to keep track of them, but you can reconcile them with a few simple clicks. Other benefits of e-remittance include:

Reducing the amount of time spent managing claims.

Utilizing electronic claims gives your staff time back each day that can be used for more important tasks. This way, you can ensure they’re using their time efficiently, which can result in reduced staffing costs as well.

Checking claims for issues before they’re submitted.

The BestRx software includes claim auditing tools that can check electronic claims for potential issues BEFORE they are submitted. That way, you can complete any prior authorizations that may be needed and correct errors to prevent processing delays.

Keeping track of claims.

You can easily monitor electronic claims once they have been submitted too. You’ll be able to quickly check a claim status, including its progress between a billing service or clearinghouse and the payer thanks to an electronic audit trail.

Expediting the claims revenue cycle.

Using electronic claims, you can submit claims to payers in seconds. Not only does that shorten the response time, but you can post payments faster too with electronic funds transfers (EFTs).

Easier claim reconciliation.

Once the claim has been processed by the payer, it’s important to reconcile it in your system to ensure the payment is accurate. PBMs are notorious for under paying claims and delaying payments for a portion of the claims submitted. Utilizing an electronic, streamlined reconciliation process enables you to keep track of your reimbursements and dispute incorrect claim payments in a timely manner as well. This way you can ensure you’re maximizing your profitability.

Managing prescription claims doesn’t have to monopolize your staff’s time. Automating the process by using electronic claims can help your pharmacy save significant time and money. Request a free demo to learn how BestRx can help your pharmacy streamline your claims process.