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RelayHealth Pharmacy Solutions launches medical billing platform

In an effort to help retail pharmacists document and bill for clinical services covered under a patient’s medical benefit plan, RelayHealth Pharmacy Solutions, which is part of the McKesson Prescription Technology Solutions business, is offering a new pharmacy platform dubbed RelayRx Medical Billing.

RelayRx Medical Billing, or RxMB, will leverage the RelayHealth network that more than 50,000 retail pharmacies currently rely on to help improve their financial performance.

RxMB works by allowing a pharmacist to check on both the eligibility and billing for a clinical service by utilizing the X12 billing pathway — a service that is used by both physicians and hospitals.

“Our retail pharmacy partners tell us every day they are eager to play an even more impactful role in improving health care across their communities and that they need technology that will allow them to do that,” Scott Genone, general manager and vice president of RelayHealth Pharmacy Solutions said.

With RxMB, pharmacists can submit eligibility checks and claims in workflow. Within workflow, they then can use the clinical documentation platform offered by Strand Clinical Technologies — or the pharmacy’s existing clinical documentation service — to document the clinical aspects of the encounter required for reimbursement. Strand also will provide other such services related to the intervention and documentation as care coordination with other members of the healthcare team.

In addition, RxMB eliminates the need for retail pharmacies to invest in a separate practice management system that can accommodate the X12 billing transaction.

Instead, pharmacy system vendors can map to the RxMB protocols and offer their pharmacy customers the additional functionality of submitting the required information for reimbursement. Multiple pharmacy system vendors have already planned efforts to incorporate RxMB into their portfolio, according to the company.
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