There are a number of challenges that pharmaceutical drug manufacturers face to ensure that patients go home from the pharmacy with their prescribed medications. If a medication isn't included in a patient's insurance plan formulary, this may lead to prescription abandonment or a different medication selection at the point of drug dispensing—which means that patient may not adhere to what was prescribed by their physician.

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Medication accessibility to improve patient acquisition and retention

RelayHealth's Denial Conversion service can help. When a claim is rejected as non-reimbursable for a qualified National Drug Code (NDC) (e.g. NDC not covered) RelayHealth will convert the rejected claim to a paid response and return the specified patient co-pay and patient savings notification. The medication is dispensed as prescribed, and the patient leaves the pharmacy on the therapy needed for improved health.

Features of Denial Conversion:
  • No coordination of benefit (COB) claim required
  • Qualified on NDC Code, National Council for Prescription Drug Programs (NCPDP) Reject Code and other parameters
  • Automated exclusion of government-subsidized plans
We can help:
  • Improve medication accessibility for patients
  • Support efficient pharmacy workflow
  • Increase patient satisfaction, acquisition and retention
  • Improve prescriber's freedom to prescribe medication that best fits their patients' needs