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 US 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.
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 service is a natural expansion of Change Healthcare's MedRx solution, which enables seamless pharmacy medical billing for items such as durable medical equipment, diabetic supplies, and immunizations.
To use the new service, pharmacies already live on MedRx Network can reach out to Change Healthcare to share their plans for either COVID-19 test collection or collection coupled with in-house laboratory testing by contacting their account management team.
Pharmacies not currently using MedRx Network solutions can learn how to access this new capability by contacting MedRx Network solution sales.
Change Healthcare (NASDAQ: CHNG) is an independent healthcare technology company, focused on accelerating the transformation of the healthcare system through the power of the Change Healthcare Platform.
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