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The healthcare industry is experiencing an unprecedented period of change driven by growth in specialty pharmacy, the shrinking of payer networks, migration of clinical services,  the shift to value based healthcare, the digitization of health information and an increasingly complex regulatory environment.  To capitalize on the opportunities created by these and other marketplace changes, pharmacies need new and strengthened capabilities that simplify the complex process to get paid, streamline eligibility verification, optimize claims and denials processes, identify underpayments, and support expansion of medical services in the pharmacy. Pharmacies therefore need a partner, now more than ever, who embraces these changes and can help them drive a successful business. 

Solutions Overview

Change Healthcare provides innovative tools to help improve patient care and drive efficiency.

  • Improve Operational Efficiency- Our high speed intelligent network provides the platform to automate claims and prescription processes that can streamline workflow and improve efficiency. Solutions are built to operate within existing pharmacy workflow and to be seamlessly available across the network. Flexible, on-demand tools offer ability to research, monitor, track and troubleshoot the process for maximum efficiency and productivity.
  • Optimize Reimbursement- Our real-time edit engine is designed to improve profitability by reducing submission errors and optimizing third-party reimbursements. Our industry-leading, real-time eligibility service can help save valuable personnel time and reduce claim denials. In addition, the ability to identify and resubmit claims that were paid based on outdated average wholesale pricing (AWP) can drive additional revenue.
  • Build Pharmacy Profitability and Customer Loyalty- We work together with you to deliver real-time, point-of-sale messaging and electronic voucher co-pay offset programs from pharmaceutical firms. These innovative programs can not only help drive revenue, but also improve customer satisfaction and loyalty.