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Overview
eRx Edit pre- and post- editing services are a suite of online, real-time third party claim error prevention and data validation tools. eRx Edit is designed to reduce submission errors, maximize reimbursements and manage risk in third-party claims. The eRx Edit services offer industry-leading features and functionality appropriate for both independent and chain pharmacy organizations.
Features for Independent Pharmacy
eRx Edit for independent pharmacy is composed of more than twelve separate “edits” which assess third party claims and either directly provide pricing improvement, or highlight margin improvement opportunities. The entire eRx Edit system and results are easily monitored via real-time web reports.
Benefits
  • Improves gross margins by increasing ingredient costs paid by third parties
  • Helps avoid underpay situations at maximum allowable cost (MAC)
  • Reduces the chance of third party audits due to DAW overuse and invalid DEA numbers
  • Helps identify excessively low cash (U&C) pricing that is reducing third party margins
  • Prevents underpaid claims caused by submitting inappropriate quantities for unit of use packages
In addition to preventing claim submission problems in real-time, eRx Edit sifts through reams of third party transaction data and creates manageable reports that when acted upon will substantially increase gross margins.
How it works
If there is an issue which requires pharmacist intervention (for example, a brand drug with generics available is submitted with a blank DAW code), the claim is returned by eRx Edit in the form of a rejection message. This message clearly identifies the problem and offers suggestions on changes to the transaction.
Once the claim passes the initial pre-edit process, the claim is returned to the switch and sent onwards to the third party. The third party response is received by the switch and passed to eRx Edit for a series of post-edit reviews. eRx Edit will add post-edit messages to the claim in the event of the claim is paid below acquisition cost or other user-definable parameter. The pharmacist always remains in control and has the option to override the eRx Edit review process.
Features for Chain Pharmacy
eRx provides pre- and post- editing services to a substantial and growing base of small, regional and national chain pharmacy organizations. Our rules-based edit engine allows us to quickly add new edits and business rules based upon industry changes and customer requirements. We invite you to contact us to learn more about eRx Edit services for chain pharmacy.
Real-time Web Reports
eRx Edit customers have full access to their third party claim and edit information from this website. Users can login at any time to monitor and investigate the health of their third-party business. The real-time reports not only show dollar value savings provided by eRx Edit but also give valuable information about competitive pricing, generic utilization, and third-party reimbursement trends.
For more detail on HIPAA, please see our page on HIPAA compliance.
Contact us today for more information about eRx Edit pre- and post- editing services.
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eRx Network provides network, reconciliation, and billing services to the pharmacy industry.  Click one of the headings below to learn more about our offerings.
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