What You Should Know:
– Change Healthcare launches a new solution that simplifies billing to bring more COVID-19 testing options to consumers.
– New service enables pharmacies to manage COVID-19 test billing within their traditional Rx claims processes, driving the potential to dramatically expand U.S. testing capabilities.
Change Healthcare, announced a new solution, MedRx that makes it easier for consumers to get COVID-19 testing in their local pharmacies. The company’s MedRx™ claims billing and consumer engagement solution for pharmacies now allows pharmacies to easily process and receive reimbursement for COVID-19 tests within their regular workflow. Pharmacies can now electronically bill for COVID-19 tests just as easily as they bill for prescriptions and flu shots.
Earlier this year, the U.S. Department of Health and Human Services authorized licensed pharmacists to order and administer diagnostic tests for COVID-19. However, pharmacy testing was complicated by the fact that many states issued their own policy restrictions, and regulations continued to shift. In addition, pharmacies are generally not equipped to manage electronic medical billing, as it requires a format not used for prescriptions. Pharmacists struggled to figure out which testing code to use for each commercial and state Medicaid plan, and how to bill for tests electronically.
Removing the Guesswork Involved in COVID-19 Claims Submission
Change Healthcare’s MedRx solution removes the guesswork involved in COVID-19 claims submission. This solution enables the expansion of pharmacy testing capabilities by empowering pharmacies to get paid for a COVID-19 test within their normal workflow. The process is simplified for both pharmacists and consumers. When a customer requests a test, the pharmacist inputs their insurance information for payment prescreening in real time. After the test is conducted, the pharmacist simply selects the correct user code and submits the claim, secure in the knowledge that claims are billed in compliance with payer policies for the test kit and sample collection.
“The healthcare industry is undergoing a digital transformation in a time of this unprecedented crisis. We are in a position to accelerate the transformation of the healthcare system through the power of our platform to help drive expanded access for testing,” said Mark Doerr, senior vice president and general manager, Pharmacy Solutions at Change Healthcare. “Simplifying the billing process for our customers helps pharmacies provide a critical community service and build an important new revenue stream.”