FutureRx Modules

FutureRx modules provide all the elements for a comprehensive pharmacy benefits program. Each module can be purchased as technology or as a service. You also have the choice to purchase modules one at a time or all at once.

Adjudication

The current PBM marketplace is dominated by archaic, inflexible, and complex legacy adjudication systems. FutureRx’s adjudication platform was built from the ground up to support complex government programs such as Medicare and Medicaid. FutureRx designed an efficient, flexible, and straightforward platform that allows users to understand the system logic, thereby enabling them to “own,” manage, and administer your government program or commercial pharmacy benefit. How many times have you been told “we cannot do that” or “we cannot complete that within your timeframe” or something similar? No more. FutureRx’s platform streamlines the process, from coding to accurate point-of-sale adjudication, providing the opportunity for you to reclaim control.

The FutureRx Advantage

All Lines of Business:

Medicare:

Services FRx can provide:

Act as a technical resource and respond to pharmacy claims and accumulator-related inquiries from operations, cross-functional or pharmacy business partners; review claim outputs to find potential issues and identify next steps to resolve those issues; submit, monitor, and prioritize claim issues/tickets for resolution; identify trends regarding code edits and business decisions that impact claim payments; understand claims-related billing and reimbursement updates as mandated by CMS or State Medicaid agencies; conduct quality checks and reviews of sample Part D claims on a routine basis to ensure proper calculations; and implement new CMS-required edits.

FutureRx modules provide all the elements for a comprehensive pharmacy benefits program. Each module can be purchased as technology or as a service. You also have the choice to purchase modules one at a time or all at once.