Getting a patient to leave the pharmacy with the right medication isn’t as simple as it sounds. If a certain medication isn’t included on that patient's insurance plan formulary, the plan will likely reject the prescription. This means the patient may receive a different medication or abandon their prescription altogether. Either way, they’re not getting the medication their physician prescribed, and your brand could lose market share.

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Mitigate the impact of denied prescription claims and boost medication adherence

If a claim gets rejected as non-reimbursable for a qualified National Drug Code (NDC), RelayHealth’s Denial Conversion solution converts the rejected claim to a paid response and returns the specified patient co-pay and patient savings notification. The medication gets dispensed as prescribed, aiding in patient medication adherence.

RelayHealth’s Denial Conversion can:

  • Improve medication accessibility for patients.
  • Support efficient pharmacy workflow.
  • Increase patient satisfaction, acquisition and retention.
  • Give physicians the freedom to prescribe medication that best fits a patient’s needs.

Simplify claim rejection change with advanced features that include:

  • No coordination of benefit (COB) claim required.
  • Qualified on NDC Code, National Council for Prescription Drug Programs (NCPDP) Reject Code and other parameters.
  • Government-subsidized plans are automatically excluded.