Pharmacy Benefits Management

The Medigent® Pharmacy Benefits Management module supports claim submission by individual transaction, in batch via standard messaging, or through manual entry. All claims are adjudicated in real-time.

Medigent Pharmacy is a full implementation of a multi-plan drug and drug product benefits delivery solution with direct support for CPhA3, NeCST, and NCPDP messaging for the online submission of pharmacy claims.

As a direct link between the service, the client, the service provider and plan structures, such as covered drugs, Medigent Pharmacy is an integrated solution for management, adjudication, patient safety and payment.

The Pharmacy Benefits Management module also includes a set of processes for managing the beneficiary and provider populations of a jurisdiction’s drug benefits program.