TransactRx has developed and operates a unique transaction platform in the healthcare marketplace it has named the Cross Benefit Clearinghouse. This highly scalable, fault tolerate transaction platform seamlessly integrates the national NCPDP based real-time pharmacy switching and PBM based transaction infrastructure and the national X12 based batch medical claim clearinghouse and payer infrastructure. The Cross Benefit Clearinghouse is independent of any specific switch or clearinghouse and can be used by any provider using any pharmacy switch or medical claims clearinghouse. Users of the Cross Benefit Clearinghouse use their own existing systems and workflows without any new software or the need to modify current software systems.
The Cross Benefit Clearinghouse enables pharmacy benefit managers and payers new freedoms in benefit design and insurance design. The platform removes the constraints on which products can be covered by medical or pharmacy benefits.
We enable PBMs to adjudicate claims submitted by Medical Providers for Infused and Specialty drugs as well as Professional Services allowing the PBM to increase their services for Plan Sponsors.
We enable Software and Technology Providers to add new transaction services to their product offerings opening new markets and increasing revenues.
We enable Retail Pharmacies to send claims for professional services and for drug products covered under medical benefits increasing customer loyalty and revenues.
We enable Payers to implement new contracting models and increase rebates for drugs covered under medical benefits.
We support drug sales efforts by deploying web based applications and transaction services for patient benefit determination and allowing easy billing of pharmacy benefit covered drugs by physicians.
We outsourced billing service providers to bill for drugs and services covered under a patient’s pharmacy benefit directly from their medical claims billing systems.