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DMERx™ - Durable Medical Equipment       

AbacusRx offers the DME option to the Visual Pharmacy Plus software as a fully integrated Medicare DME claims processing feature.  The DME Billing module is integrated at the point-of-sale using the Visual Pharmacy Plus™ enhancements as an additional on-line third party.   The Visual Pharmacy Plus™ software provides pharmacies a convenient and centralized method for billing Medicare claims at the point-of-fill, eliminating the need for additional costly software.  This all-in-one integration insures accuracy while significantly improving processing efficiency and opera

Our real-time edits enforce compliance to CMS (formerly HCFA) policy significantly reducing costly rejects.  The Medicare claims are thoroughly and effectively processed, with adjudication taking place within a secure and efficient environment.  Assignments are accepted by pharmacy or patient and payment is remitted to pharmacy, corporate office, or patient.

Process your Medicare DME claims real-time by transmitting the DME claim just like any other on-line third party.

The Pharmacy Plus software provides pharmacies a convenient and thorough method for billing Medicare claims point-of-fill through the Pharmacy Plus software eliminating the need for additional costly software.

The Medicare claims are thoroughly and effectively processed.

Assignment accepted by pharmacy or patient and payment remitted to pharmacy, corporate office, or patient.

Coordination of benefits handled whether Medicare is the primary or secondary insurer. Other insurance amounts automatically reported to participating secondary insurer.

Each claim is processed at the point-of-fill and the complete
claim is captured:

Edits include, but are not limited to:

Doctor NPI, DEA, UPIN number and demographic verification.
Patient ID and demographic verification.
Product coverage and automatic modifier determination.
MAC price, minimum/maximum quantity verification.
Diagnosis code to product verification.
Coordination of Benefits, and patient/pharmacy assignment.
Refill too soon and patient annual deductible verification.
Automatic quantity conversions from pharmacy to CMS standards.
Non-covered items may be submitted when required by state medicaid.
Date Spanning compliance enforced on diabetic and enteral supplies.
Backend Research & Resubmit service available to all providers.
After your claim has passed the extensive edit checks, a response is instantly returned to your system.


Insurance Claims:

HCFA Claim Forms

We carry forms that meets current CMS requirements and is available in continuous or sheet format, one or two-parts. Our non-continuous forms can be imprinted with your pracitice's information and are available with or without bar code.

  • CMS-1500 Insurance Claim Forms
  • Insurance Claim Envelopes
  • UB-92 CMS-1450 Claim Forms
  • CMN Forms for Durable Medical Equipment

 

Register online (Register) or call us
directly at 305-220-0400.
 

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