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TransactRx Files Patent Application for Cross Benefit Clearinghouse Services
Date:11/26/2013

Coral Gables FL (PRWEB) November 26, 2013

TransactRx, the nation’s leading Medicare Part D Vaccine Physician Billing Service, announced today the filing of the first of what is expected to be a series of patent applications for technology components of its Cross Benefit Clearinghouse™. The patent application titled a ‘SYSTEM AND METHOD FOR MEDICAL BILLING SYSTEMS TO SUBMIT TRANSACTIONS FOR SERVICES COVERED UNDER PHARMACY BENEFITS’ covers one subset of functionality included in the overall set of technology and functionality in the Cross Benefit Clearinghouse™.

The patent covers a set of functionality related to medical billing and other systems based on X12 transaction standards that provides the capability to exchange transactions with pharmacy benefit managers and other entities whose systems are based on the NCPDP transaction standard. The functionality included in the patent application includes:

  •     Cross Benefit Eligibility – The ability for medical billing systems using their standard medical benefit eligibility module to determine a patient’s pharmacy benefit eligibility.
  •     Cross Benefit Coverage Predetermination – The ability for a medical provider to determine a patient’s financial responsibility for a particular drug product under their pharmacy benefit using their standard medical benefit eligibility module.
  •     Cross Benefit Real-time Claims Processing – The ability for a medical billing system to submit an X12 based claim transaction in real time which will be processed by the patient’s pharmacy benefit manager and in real time provide a claim response to the medical provider.
  •     Cross Benefit Batch Claims Submission – The ability for a medical billing system to submit batches of X12 based claims in their normal workflow which are the
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