APCI Choice Clinical and Claims Management

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APCI CHOICE is the evolution of clinical services and claims management for independent pharmacy!

CHOICE Clinical & Claims Management is the name of the new claims management and clinical services division of APCI! Formerly known as American Pharmacy Network Solutions (APNS), CHOICE will continue to provide the customer service and personal relationships APCI members have come to expect, and offers the following services:

ResolveRx: ResolveRx reconciliation ensures third-party payments match the claims processed during adjudication, down to the claim level.

PRO Wellness: Through CHOICE’s partnership with PrescribeWellness, the PRO Wellness dashboard offers a wide range to tools and information to members.

Pre/Post Edits: Automated actionable claim messaging enables a pharmacy’s staff to make faster, more informed decisions needed to improve revenue potential and productivity.

Medversant: CHOICE’s partnership with Medversant provides continuous roster monitoring for licensing, DEA, OIG, SAM, and state sanctions.

Comprehensive Audit Prevention Services (CAPS): CAPS is designed to equip independent pharmacies with the assistance and tools needed to successfully navigate through the audit process.

Joint Venture Management of Health Mart Atlas: CHOICE will serve as an intermediary to the new Health Mart Atlas joint venture PSAO. While specific roles and responsibilities have not yet been established, CHOICE Clinical and Claims Management expects to receive valuable insight regarding quality and clinical initiatives.

Chronic Care Management: Chronic Care Management is a patient care model centered around Medicare Part-B billable services, including transitions of care, medication reconciliation, and chronic care management. Chronic Care Management services require a mechanism for submitting medical claims for Part-B reimbursement, typically in conjunction with a collaborative agreement with physicians.

Telemedicine: As healthcare evolves, pharmacy integration and telemedicine kiosks can allow pharmacies to become healthcare destinations, providing real-time, on-demand health services using the latest technology for connectivity.

Our ability to respond personally and quickly to our members' needs sets us apart from other providers. Every Choice staff member is an expert in their field, and we're here to guide you. Whether it is by telephone, via remote desktop computer tutorials, or through one-on-one sessions with our staff, Choice develops lasting relationships with our community pharmacists!


Features:

  • A host of specialized solutions, tailored just for APCI members
  • Proven reliability you can trust
  • Exclusive, value driven programs
  • Support staff backed by years of industry experience, focused on independent pharmacy
  • 24/7 access to secure web solutions
  • ResolveRx reconciliation services
  • Industry's lowest monthly fee

Benefits:

  • Increase the value of your current APCI membership
  • Expect higher profitability
  • Cash flow improvement
  • Easy claims reconciliation
  • Better utilization of pharmacy staff
  • Potential to increase customer base
  • Maintain competitive edge with national chains
  • Eliminate missing claims money

ResolveRx

Resolve Rx is a simple, easy to use organizational platform that will help you track down claims with the click of a button. No more searching through stacks of paper to find that unpaid claim - claims can now be accessed through the APCI website similar to the way you would look up Online Remittances.

Click here for more information on ResolveRx


PRO Wellness

Through CHOICE’s partnership with PrescribeWellness, the PRO Wellness dashboard offers a wide range to tools and information to members, including:

  • Patient Engagement Center – The Patient Engagement Center offers pharmacies a real-time snapshot of performance and opportunities. Visualize and act on patient data to instantly see opportunities for better service, increased adherence, and revenue growth.
  • Vaccine Complete - An instant vaccine eligibility profile for every patient based upon CDC guidelines. Allows pharmacies to realize missed vaccine opportunities, increase vaccination rates, improve population health and increase alternative revenues.
  • PrescribeMedicare - Medicare plan comparison tool that allows pharmacies to assist their patients in selecting the most appropriate plan for their needs.
  • Med Sync - Allows pharmacies to manage maintenance medications for patients on an ongoing basis by syncing the fill dates. Med Sync increases adherence, drives performance, increases revenues by decreasing missed fills, and allows for more predictive workflow and inventory management.
  • Prescribe Care - Electronic care plan that allows pharmacies to participate in patient care coordination for improved health outcomes. Prescribe Care also allows for documentation of medication therapy problems and progress notes.
  • Biometric Screenings - A patient engagement center enhancement that allows for the uploading of patients’ biometric data (height, weight, A1C, BMI) and integrates with patients’ medication profile.