By partnering with a leading health insurance enrollment provider, OmniSYS will be integrating Medicare prescription plan comparison capabilities into its patient communication and Electronic Health Record (EHR) solutions, providing pharmacists and patients easy access to health insurance and prescription benefit plans that meet the needs of both the patient and the pharmacy.
What does OmniSYS do?
OmniSYS is a technology company with 25+ years of experience working with pharmacies, payers, providers and pharmaceutical manufacturers. We leverage this unique market insight along with our pharmacy workflow expertise to deliver valuable solutions that help pharmacies thrive in the changing pharmacy landscape.
What is CareCLAIM?
CareCLAIM® is the pharmacy industry's leading medical claim billing solution, trusted by over 30,000 pharmacies across the country to optimize reimbursement on medical claims.
Who is OmniSYS?
OmniSYS is a technology company with 25+ years of experience working with pharmacies, payers, providers and pharmaceutical manufacturers. We leverage this unique market insight along with our pharmacy workflow expertise to deliver valuable solutions that help pharmacies thrive in the changing pharmacy landscape.
What is the difference between encounters and claims?
Encounter data are similar to FFS claims data, but encounter data (1) are not tied to per-service payment from the state to the managed care organization (MCO), because the state is not paying for individual services, and (2) do not include a Medicaid-paid amount, although many states collect the amounts MCOs pay ...
Where do you want to start?
OmniSYS is committed to helping retail pharmacists provide convenient, affordable and quality care to the communities you serve. How can we help you get started?
How OmniSYS Helps Pharmacies Succeed
"It’s very rare these days to have a situation in healthcare where everybody wins. But this is one. Pharmacists are able to give a pneumonia shot that might not have happened otherwise, and at zero cost to the patient.
Does Medicare cover immunosuppressive therapy?
Medicare covers a beneficiary’s immunosuppressive drugs following a transplant in accordance with 1861(s)(2)(J) of the Social Security Act (the Act), which states that Medicare covers “prescription drugs used in immunosuppressive therapy furnished to an individual who receives an organ transplant for which payment is made under this title.”
What is MLN matter?
This MLN Matters Special Edition (SE) Article is intended for pharmacies billing Durable Medical Equipment Medicare Administrative Contractors (DME MACs) for immunosuppressive drugs provided to Medicare beneficiaries who received an organ transplant that was paid for by Medicare.
What is CR 10235?
Change Request (CR) 10235 highlighted updated language in the Medicare Claims Processing Manual, Chapter 17, Section 80.3. (Billing for Immunosuppressive Drugs) regarding the use of the KX modifier for certain claims for immunosuppressive drugs. See the related MLN Matters article
