Our unique platform facilitates new types of business relationships between healthcare providers, insurers, PBMs and all types of healthcare entities that otherwise would have been impossible to create.
Coral Gables, FL (PRWEB) April 05, 2016
TransactRx announces the release of Version 2.0 of its Cross Benefit Clearinghouse Platform. Originally deployed in 2013, the new release enhances the platforms functionality and external system integration. Key updates include enhanced support for conversion of X12 Professional Medical Claims to NCPDP Pharmacy Claims. Additional functionality enables the processing of infused and specialty drug claims submitted as professional medical claims (converting JCodes and HCPCS to the appropriate NDC and dosing quantity). New functionality includes support for medical drug rebate submission by payers.
The unique cloud based, patent pending transaction platform seamlessly integrates the nation’s real-time pharmacy switching infrastructure with the nation’s batch medical claims clearinghouse infrastructure. It provides functionality to convert in real-time between NCPDP formatted and X12 formatted eligibility, claims and remittance transactions. Additionally, the system has robust payment processing functionality that facilitates translating claim status and remittance advice transactions into formats and with content that can be processed automatically by the submitting platform. The platform is one of the first to fully support the NCPDP S1 transaction set. The Cross Benefit Clearinghouse can be “plugged into” any current implementation of pharmacy or medical software, pharmacy switches and medical claims clearinghouse connections without any software modification requirements.
“Insurers are seeking new benefit designs to best optimize risk models and move drugs and services between medical benefits and pharmacy benefits. This presents new transaction processing requirements and challenges”, says Jack Guinan, CEO of TransactRx, “Our unique platform facilitates new types of business relationships between healthcare providers, insurers, PBMs and all types of healthcare entities that otherwise would have been impossible to create. We are excited about the new functionality we are able to provide to the marketplace and the projects we are getting involved in with many industry leaders.”
POC Network Technologies, Inc. d.b.a. TransactRx provides cloud based transaction services that enable a seamless real-time interface between the medical and pharmacy claims processing infrastructures for Benefit Managers (PBMs, Health Plans, Billing and Technology Providers) . Using existing systems, the TransactRx proprietary Cross Benefit Clearing House and Population Health Management Platforms provide unique and flexible solutions to help manage any type of benefit no matter if it is on the Medical or Pharmacy spend.