Medicare Part B Processing for Mail Order Pharmacy

OmniSYS provides claim submisssion services to mail order pharmacies for DME/HME items, supplies and drugs, allowing these pharmacies to submit claims just like any other third-party prescription. Our Medicare Part B Service, CareCLAIM works with any pharmacy system that processes electronically, requiring no additional hardware or software and little or no training. The mail order pharmacy Supplier experiences the look and feel of any other third-party plan and receives real-time responses that include expected amounts due from the primary and secondary payor as well as applicable patient coinsurance.

We perform over 400 proprietary edits to ensure compliance with Medicare and provide real-time responses to minimize unnecessary claim rejections. Pharmacy Suppliers don’t have to understand medical policies for coverage criteria, procedure codes or modifiers in order to submit claims. The Medicare Allowable Charge, coinsurance and patient deductibles are tracked and calculated based on assignment and coverage, ensuring the Supplier collects the correct co-pay from patients.

When you use OmniSYS’ Medicare Part B Claims Processing, you receive the highest level of customer service, through real-time claims processing including prompt reimbursement, leading to improved prescription volume and increased revenue.

Click on these additional services to learn more:

Denial Tracking, Claims Correction/Resubmission

Electronic Remittance Posting

Eligibilty Verification System

EOB Posting

Patient Invoicing

Reporting Packages

OmniSYS Medicare Part B Covered Classes:

  • Canes & Crutches
  • Commodes
  • Continuous Positive Airway Pressure System (CPAP)
  • Diabetic Shoes
  • Diabetic Supplies
  • Enteral Nutrition
  • Erectile Aids
  • External Breast Prosthesis
  • Hospital Beds
  • Immunizations (including Flu & Pneumonia)
  • Immunosuppressive Drugs
  • Infusion Pumps
  • Knee, Ankle & Foot Orthoses
  • Manual Wheelchairs
  • Motorized Wheelchair Bases
  • Nebulizer Compressors
  • Nebulizer Compressor Accessories
  • Oral Anti-Cancer Drugs
  • Oral Anti-Emetic Drugs
  • Ostomy Supplies
  • Patient Lifts
  • Prosthetics & Orthotics
  • Respiratory Medications
  • Seat Lift Mechanisms
  • Spinal Orthoses Supplies
  • Suction Pumps
  • Surgical Dressings
  • Tracheostomy Supplies
  • Urological Supplies
  • Wheelchair Accessories
  • Wheelchair Seating
  • Support:
    800.666.4797
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    24 hours a day
  • Sales:
    800.448.6891
  • Local:
    903.455.0461
  • Fax:
    903.455.7910
  • E-mail:
  • Call us today at 800.448.6891

Enroll today by calling 800.448.6891 or click here to contact us.