Services Directory: Billing Services

Provides a convenient solution for electronically billing Medicare and Medicaid DME claims at the point-of-service via QS/1's systems. Real-time edits verify patient ID, doctor DEA/NPI, diagnosis code, quantity, Maximum Allowable Cost (MAC) price, refill demographic information and more. It handles coordination of benefits and allows assignments to be accepted by the pharmacy or patient.

Provides electronic DME claims processing for Medicare, Medicaid and private pay/third parties and works with QS/1's pharmacy systems without the need to purchase additional software. It automates bills for recurring rentals, handles secondary billing automatically or manually, simplifies held or rejected claims and reconciles DME claims.

Enables pharmacies to efficiently and cost-effectively transmit and process Medicare claims with a solution that can be customized to meet the unique needs of any organization.

TransactRx, now a RedSail company, helps pharmacies provide vaccines and clinical services and capture more revenue – preventing underbilling, improper coding, or missing information.

• Payment rate near 100%
• Patient eligibility check in real time with follow-up information
• Real-time edits to minimize delayed or denied claims
• Proactive claims status management for all payer rejected and zero pay claims

Provides print, mailing and e-Document delivery for your monthly charges and statements. Customers upload state files each month via their QS/1 systems, and VFI postal sorts, copies, folds, inserts and mail statements with a return envelope. It helps you market the service to your patients and allows them to sign up via your website. Your patients can then view, download and pay their statements electronically.

Provides a web-based DME billing solution for sending claims electronically in an 837/5010 format file to third parties. It offers eligibility and same or similar checking, payment-collection solutions. It provides the option to edit claims on the Waystar website and maintains up-to-date information on changing governmental regulations, payer policies and payment models. The new denial management option tracks and manages denial workflow from start to finish. Users can drill down into data for clear reporting on financial impact and staff productivity.