In today's Specialty Pharmacy market the allocation of the benefit design is estimated to be 50% on the pharmacy benefit and 50% on the medical benefit. This means that half the time you are either billing the Pharmacy Benefit Manager (PBM) benefit or the Health Plan. The percentages will vary depending on the disease state(s) you support, but in either case, if you are a Specialty Pharmacy billing medical claims you are full aware of the additional pain that it creates. There is a lot more front-end work to verify eligibility, understand patient co-pay or even know if a pre-authorization is required.

1. Specialty Pharmacy Medical
Benefits Billing
Visit our Website : www.transactrx.com

2. Specialty Pharmacy Medical
Benefits Billing
In today's Specialty Pharmacy market the
allocation of the benefit design is estimated to
be 50% on the pharmacy benefit and 50% on
the medical benefit. This means that half the
time you are either billing the Pharmacy Benefit
Manager (PBM) benefit or the Health Plan.

3. Specialty Pharmacy Medical
Benefits Billing
The percentages will vary depending on the
disease state(s) you support, but in either case, if
you are a Specialty Pharmacy billing medical
claims you are full aware of the additional pain that
it creates. There is a lot more front-end work to
verify eligibility, understand patient co-pay or even
know if a pre-authorization is required.

4. Specialty Pharmacy Solution
The TransactRx Cross Benefit Platform provides a solution
to this problem :
•Submit your medical claims directly from you existing pharmacy
system
•Real-time eligibility and patient responsibility response using
standardized NCPDP message codes

5. Specialty Pharmacy Solution
• Benefit design rules and edits can be loaded and managed by the
system
• Cross Benefit coding and billing rules are built into the system
• The TransactRx Cross Benefit Clearinghouse converts the claim
into a properly formatted ACS X12 and submits to Medicare Part B
or commercial payors using your existing contracts

6. Specialty Pharmacy Solution
• TransactRx manages the submission, collections and reconciliation
of all claims. TransactRx pays you twice a month on all collections
received within the previous cycle
• TransactRx provides you with a detailed remittance advice and an
835 file than can be easily downloaded directly into your pharmacy
software system.

7. Specialty Pharmacy Solution
Specialty Pharmacies of all types that have a mix of claim
processing needs that span both pharmacy benefits and
medical benefits can lower billing and collection costs,
increase efficiencies and remove one of the headaches
from your business so that you can focus on patient care.

8. Contact Us
Customer Care Services:
5146 W. Whispering Wind Dr
Glendale, AZ 85310
Telephone: 866-522-3386
Sales Office:
5146 W. Whispering Wind Dr
Glendale, AZ 85310
Telephone: 800-971-3890
Corporate Office & General Inquiries:
999 Ponce de Leon Blvd, Suite 515
Coral Gables, FL 33134
Telephone: 800-971-5500
Visit our Website : www.transactrx.com