Our enhanced credentialing program and compliance training program provide expert educational information, including policies and procedures. Tracks include training for compliance with OSHA regulations, pseudoephedrine dispensing guidelines, HIPAA compliance, preventing fraud, waste and abuse, and more.
Improve reimbursements and streamline workflow on every paid claim. Our performance suite is your one-stop source for pre- and post-editing across pricing, clinical and operational metrics, including AWP resubmission, operational edits, DAW lookups, DEA, NPI, state-specific edits, Risk Evaluation and Mitigation Strategy (REMS) requirements, and more.
Our reconciliation services include central pay but do not require it – our commitment to reconciling every claim and recovering all unpaid funds extends to direct pay arrangements as well. Communication is managed efficiently through our member portal, and service excellence comes standard, regardless of how you choose to receive your claims payments.
To help pharmacies save time with electronic transaction reporting and claims reconciliation, we can produce and provide 835 files. We can push the 835s to our member portal for your pharmacy to view and import, or if you use a different reconciliation vendor, we can send the 835 files directly to your vendor’s SFTP site.
Take control of cash discounts and offer competitive, consistently priced medications – without high transaction fees. Our Value Card Cash Plus program enables you to run cash claims through our card instead of the high-fee cards cash customers receive elsewhere. Choose from an extensive range of group numbers with various reimbursement rates to ensure your patient still receives the discount, but at reduced costs to your pharmacy – and with opportunities to earn cash claim rebates as well.
Whether you need $4 generics, $6 generics or $10 generics to stay competitive but profitable in your market, our PromiseRx Complete program has you covered. In keeping with our commitment to flexibility and being your partner in excellence, we can tailor our program to meet your unique generic pricing needs.
We do not mandate use of any specific clinical management platforms – on the contrary, we can support implementation and even facilitate deep member discounts for other programs – but we do encourage our member pharmacies to use our performance management tool, powered by EQUIPP. Through our partnership with EQUIPP, we provide visibility into pharmacy-level quality scoring – and through our commitment to pharmacy excellence, we dive into the data and engage pharmacies in adherence campaigns that improve rankings.
We facilitate access to all MTM platforms to bring our members seamless access to MTM opportunities and additional revenue generating interventions. Our in-house pharmacists also provide personalized support, making it easier for pharmacies to operationalize and manage their MTM service offerings.
It’s easy to join Pharmacy First, and you will see the benefits right away. Contact us to learn more about what makes us the right PSAO for you.
