The TransactRx Medical Drug Rebate System (MDRS) is a complete system supporting all functionality required to load Drug Manufacturer rebate contract details, import drug administration information from pre and post adjudication professional medical claims data, create medical drug rebate invoices and transmit them to the appropriate manufacturer. The MDRS is based on industry standard data formats and can be implemented by a Medical Benefit Plan/Payer with very little IT resources and in a short amount of time.
The TransactRx MDRS platform is made up of two components; the MDRS Invoicing Module and the MDRS Aggregator Module. The MDRS Invoicing Module is implemented by a Payer that has its own Medical Drug Rebate contracts or is contracted with an aggregator that owns the rebate contracts. The MDRS Aggregator Module is implemented by an organization that owns Medicare Drug Rebate contracts and acts as an aggregation point for sub-contracted entities to submit their rebate invoices or drug administration information and then combines data into consolidated rebate invoices for transmittal to manufacturers.
The TransactRx MDRS Invoicing Module is implemented as a service with nothing required to be physically deployed at the payer site. The interface to the MDRS invoicing module can be deployed using standard X12 837 professional claims and X12 835 electronic remittance advice data records. At the request of the payer the interface can use mutually agreed to proprietary data feeds as well. The MDRS Invoicing Module can be implemented as a complete solution for payers with their own rebate contracts or as a method of transmitting data to a rebate aggregator.
Functional Specifications of the MDRS Invoicing Module include:
The TransactRx MDRS Aggregator Module is deployed as a service with nothing required to be physically implemented at the Rebate Aggregator site. The MDRS Aggregator Module can receive data from the MDRS Invoicing Modules implemented by various payers or from any other system capable of implementing a data feed to the Aggregator Module. The MDRS Aggregator Module supports all the functionality to load and manage manufacturer rebate contracts for any number of drugs.
Functional Specifications of the MDRS Aggregator Module include:
TransactRx has been providing cloud based healthcare transaction services to the nation’s leading payers, pharmaceutical manufacturers, pharmacy benefit managers and provider organizations since 2007. The TransactRx technology platform was built from the ground up using the latest cloud based technologies and methodologies. Nine years later this platform is the most advanced cloud based transaction platform in the industry. A patent is pending on key components of the platform.
TransactRx has named its transaction platform the Cross Benefit Clearinghouse ™.This highly scalable, fault tolerate transaction platform seamlessly integrates the national NCPDP based real-time pharmacy switching and PBM based transaction infrastructure and the national X12 based batch medical claim clearinghouse and payer infrastructure. The Cross Benefit Clearinghouse is independent of any specific switch or clearinghouse and can be used by any entity using any pharmacy switch or medical claims clearinghouse. Users of the Cross Benefit Clearinghouse use their own existing systems and workflows without any new software or the need to modify current software systems.
Some of the customers using the Cross Benefit Clearinghouse to enable their strategic technology initiatives include CVS Health, Humana, Merck & Co., Rite Aid Corporation, AthenaHealth, ExpressScripts and many other leading healthcare entities.