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Glossary of Terms
 

SERVICES OFFERED

Remote Claims Processing ("ASP") at less than $0.09 per claim

      DpRx offers its oldest service to users that wish to manage their own Pharmacy Benefit program. The user is connected to the DpRx data center by the Internet and can manage their inquiry and PAR requests with an online Help Desk facility and provide updates and maintenance to the eligibility database online. (In today’s IT world such a service is called Application Service Provider or "ASP".

     The reader is referred to the Software Products section to be provided a more detailed description of the DpRx software which all falls under the management of the TeleCLAIM system.

     If the user is currently operating under the control of a PBM vendor the conversion to this service requires delivery of a compatible eligibility and history database. If both data files are provided in the industry standard format provided by NCPDP, there is no special customizing work required for conversion. In such a scenario, the DpRx ASP approach can be implemented in 30 days. Of course, the user must organize and train their own Help Desk and Pharmacy staff, which may take longer.

     In a similar scenario for users that presently have remote processing, the transition may be even simpler since there is no creation and staffing of a Help Desk and collateral pharmacy support.

     DpRx provides this service at most competitive rates. Most often, the $0.04 per transaction rate is used with a flat license fee. The final price is influenced by the monthly claims volumes involved and the duration of the license agreement.

     For those users without current connectivity with Pharmacy networks, there needs to be an organizing effort to secure provider contracts and a general carrier that connects with the ordinary independent Pharmacies and the Drug Chains.

     The existing in-store pharmacy management systems, although conforming to NCPDP standards for connectivity, may not have hardware/software that allows a direct connection to the processor system. Carriers like NDC, Envoy or Medamerica must be contracted with at this time to forward transactions to the DpRx data center using Internet compatible technology of TCP/IP transmission protocol. DpRx is ready for future transmission by the Internet when the providers are upgraded.

     (In South America wireless systems exist for connectivity that allow direct connections to the DpRx data center without the need for a translation to another protocol with the data center.)

     In this service, the user is in complete control of the functional aspects of the claims processing. The user creates its own benefit plans, maintains its own eligibility data files, sets and maintains its own formulary or formularies, manages its own Help Desk and overall uses the DpRx computer resources as if they were the user’s own software.

 
 

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