Pharmacy Billing
Built For Pharmacy Revenue
CoreMedX Health provides pharmacy billing solutions designed to simplify reimbursements and improve operational efficiency. We help pharmacies manage claims, payer communication, and reimbursement workflows with accuracy and consistency.
Pharmacy Billing
Every Prescription, Paid In Full.
Each service is run by pharmacy billing specialists and tracked in real time — so claims adjudicate clean, rejections get worked, and reimbursements reconcile to contract.
Pharmacy Claim Submissions
Every claim scrubbed against payer and PBM edits before adjudication NDC, DUR, quantity, and days-supply checks catch rejections at the counter, not at the month-end.
98.4% first-pass clean claim rate
Learn More →
PBM Coordination
Reject codes investigated, DUR and prior-auth issues resolved, and remittances reconciled against contracted rates — every rejection treated as recoverable, not a write-off.
2 hrs average reject-to-resubmit turnaround
Learn More →
Reimbursement Management
Every payment posted and reconciled against expected contract rates, catching DIR fees and short-pays before they quietly shrink your spread.
99% reimbursements reconciled, same day
Learn More →
Pharmacy Claim Submission
Claims Adjudicated Right. The First Submission.
Pharmacy claims reject for reasons retail teams rarely have time to chase NDC mismatches, DUR conflicts, quantity and days-supply errors, missing prior auths. CoreMedX scrubs every claim against payer and PBM edits before adjudication, so rejections are caught at the counter, not at month-end.
Real-time claim status across commercial, Medicare Part D, and Medicaid means your team sees exactly which claims paid, which reversed, and which need rework — without logging into a dozen portals.
PBM Coordination
Every PBM Rejection Worked. Not Written Off.
Most pharmacies absorb PBM rejections and underpayments as a cost of doing business. CoreMedX treats every rejection as recoverable investigating reject codes, resolving DUR and prior-auth issues, and resubmitting with the right documentation within hours.
We reconcile PBM remittances against contracted rates and flag underpayments and clawbacks before they erode margin, so you collect what each prescription actually earned.
Reimbursement Management
Reimbursements Reconciled To The Penny.
Pharmacy margins live and die on accurate reimbursement. CoreMedX posts and reconciles every payment against expected contract rates, catches DIR fees and short-pays, and surfaces the trends that quietly shrink your spread.
Monthly reimbursement reporting shows you which drugs, payers, and PBMs drive your revenue and where it’s leaking so you can act before it shows up on the P&L.
Measured Results
Numbers That Define Our Standard
Clean Claim Rate
First-pass acceptance rate across all payers, commercial, Medicare, and Medicaid.
Learn More →
Avg Reject Turnaround
Denied claims overturned on appeal, versus a 42% average for in-house billing teams.
Learn More →
Reimbursement Posted
Average days from claim submission to payment posting, versus a 38-day industry average.
Learn More →
Unworked Rejections
Average improvement in net collections within 6 months for practices onboarded to CoreMedX.
Learn More →
Stop Leaving Pharmacy Revenue On The Counter.
Book a free 20-minute billing review with a CoreMedX pharmacy specialist. We’ll show you exactly where rejections and short-pays are costing you no commitment, no obligation.