Full-Service Claims Adjudication
A benchmark for the industry, RxLogic's full-service, real-time claims adjudication solution gives stakeholders across the healthcare ecosystem complete control over clinical, financial and operational workflows. Our independent, API-driven platform ensures transparency, compliance and scalability, allowing clients to streamline operations, optimize costs and make data-driven decisions across the entire pharmacy claims lifecycle.
What Sets RxLogic Apart
Scalability & Reliability
Built upon Microsoft Azure, infrastructure supports high transaction volumes with 99.999% uptime and isolated client resources.
Customization & Flexibility
SaaS-based platform adapts to clients' unique requirements, reducing the need for manual adjustments.
Transparent Rebate Administration
In-depth, claim-level rebate reporting supports real-time savings insights.
Security & Compliance
RxLogic is fully HIPAA and SOC II-compliant, with robust data security protocols.
No Conflict of Interest
RxLogic's commitment is to serve as a dedicated partner to PBMs, providing the tools and support needed to excel without any conflicting interests.
Independently Operated Technology Platform
RxLogic is not a PBM and does not retain rebates, steer claims or monetize spread pricing. This ensures clients have full control over plan design, data access and vendor relationships.
Comprehensive PBM Solutions for Strategic Success
RxLogic delivers a connected ecosystem as an agnostic aggregator managing a robust and flexible network partner solution, empowering seamless connectivity across pharmacies, discount card vendors, e-voucher providers, copay programs and ancillary pharmacy claims adjudication services.
Real-Time Claims Adjudication
Seamless integration with national claims switches, external pricing sources, benefit partners and numerous POS-integrated partners. This cohesive connectivity streamlines the entire adjudication process.
Formulary & Benefit Plan Management
Through a robust web interface, clients can design and control benefit plans, adjust pricing and oversee formulary management in real time with full transparency in claims processing logs.
Financial Management
Automate the entire financial administration process, including issuing payments, managing invoices and handling receivables with comprehensive remittance advice following ANSI X12 835 formats.
Rebate Administration & Optimization
Maximize rebates, reduce net costs and customize formularies with passthrough and minimum guarantee arrangements, underwriting tools and flexible financial strategies.
Service Modules for Client Support
The Job Ticket Tracker and Call Assist modules improve customer service efficiency, manage incoming client queries, support workflows and operational issues effectively.
Seamless Data Integration & Migration
API-driven architecture ensures clients can integrate RxLogic effortlessly with existing eligibility, billing and EHR systems with easy transition from legacy systems.
Advanced Reporting & Analytics
Real-time data access with detailed analytics on transactions, network performance and rebate validation tools to support data-driven decision-making.
Ready to Transform Your Claims Processing?
Schedule a demo to see how RxLogic's claims adjudication platform can streamline your operations.
Schedule a Demo