TransactRx, the nation’s leading Medicare Part D Vaccine Physician Billing Service, announced today the filing of the first of what is expected to be a series of patent applications for technology components of its Cross Benefit Clearinghouse™.To learn more, please visit http://www.transactrx.com/cross-benefit-clearinghouse
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TransactRx Files Patent Application for Cross Benefit Clearinghouse Services
1. TransactRx Files Patent Application for Cross Benefit Clearinghouse Services
TransactRx, the nation’s leading Medicare Part D Vaccine Physician Billing Service, announced today the filing of
the first of what is expected to be a series of patent applications for technology components of its Cross Benefit
Clearinghouse™. The patent application titled a ‘SYSTEM AND METHOD FOR MEDICAL BILLING SYSTEMS
TO SUBMIT TRANSACTIONS FOR SERVICES COVERED UNDER PHARMACY BENEFITS’ covers one subset
of functionality included in the overall set of technology and functionality in the Cross Benefit Clearinghouse™.
The patent covers a set of functionality related to medical billing and other systems based on X12 transaction
standards that provides the capability to exchange transactions with pharmacy benefit managers and other
entities whose systems are based on the NCPDP transaction standard. The functionality included in the patent
application includes:
Cross Benefit Eligibility – The ability for medical billing systems using their standard medical benefit eligibility
module to determine a patient’s pharmacy benefit eligibility.
Cross Benefit Coverage Predetermination – The ability for a medical provider to determine a patient’s financial
responsibility for a particular drug product under their pharmacy benefit using their standard medical benefit
eligibility module.
Cross Benefit Real-time Claims Processing – The ability for a medical billing system to submit an X12 based
claim transaction in real time which will be processed by the patient’s pharmacy benefit manager and in real time
provide a claim response to the medical provider.
Cross Benefit Batch Claims Submission – The ability for a medical billing system to submit batches of X12
based claims in their normal workflow which are then submitted as NCPDP real-time pharmacy claims to the
appropriate pharmacy benefit manager.
Cross Benefit Electronic Remittance Advice Processing – The ability to receive electronic remittance advice
transactions from pharmacy benefit managers and convert them to be able to be applied against claims
submitted from medical claims systems.
“As we look forward at the activities in the healthcare marketplace there is an increasing blurring of lines between
the types of services offered by medical and pharmacy providers and the products and services covered by
medical and pharmacy benefits,” says Jack Guinan, CEO of TransactRx. “We see our Cross Benefit
Clearinghouse™ technology playing a key role in deploying new models of service distribution and benefit
design.”
ABOUT TRANSACTRX
POC Network Technologies, Inc. d.b.a. TransactRx is a leading national provider of reimbursement solutions for
vaccines and specialty pharmaceutical products administered at the point-of-care. The TransactRx proprietary
technology platform seamlessly connects the nation’s pharmacy and medical transaction infrastructures to enable
physicians, public health departments and pharmacies to check coverage information and submit claims for both
medical and pharmacy benefits. The Company’s unique national provider networks significantly reduce the cost
and effort associated with contracting a large numbers of providers to administer a particular vaccine or group of
pharmaceutical products. The combination of technology and provider networks assists payers of all types
including Medicare, Medicaid, Commercial and Self-Funded Employer plans.
To learn more, please visit http://www.transactrx.com/cross-benefit-clearinghouse.