Solutions

Pharmacy operations

Helping pharmacies stay ahead of evolving industry demands with configurable solutions that span the healthcare ecosystem.

Two pharmacists reviewing a computer monitor in a pharmacy setting.

The challenge

Many pharmacies face challenges in managing the high volume of prescriptions, adjudicating claims quickly and accurately, staying compliant with regulations, and maintaining both productivity and profitability. To keep pace with the ever-changing industry, pharmacies need scalable solutions that meet their unique patient care objectives and business goals.

  • 35%

    Increase in audit costs[0]KFF Health News, Pharmacies Face Extra Audit Burdens That Threaten Their Existence, Aug 6, 2021

    The average audit in 2020 cost a pharmacy $23,978 — 35% more than the annual average over the previous five years.

    Illustration: The average audit in 2020 cost a pharmacy $23,978 — 35% more than the annual average over the previous five years.
  • 40%

    of pharmacists[0]CoverMyMeds Provider & Pharmacist Surveys, 2022

  • 80%

    of patients [0]CoverMyMeds Patient Survey, 2022

Pharmacy operations benefits

CoverMyMeds’ comprehensive Pharmacy Operation solutions help more than 50,000 U.S. retail pharmacies optimize financial and operational performance with products that assist with audit protection, reimbursement management, patient safety and operational efficiencies.

  • Minimize claim submission errors & help achieve maximum reimbursement

    We monitor average wholesale price (AWP) changes for you and help you recover lost dollars on third-party transactions by reviewing, reversing and resubmitting claims.

  • Enable better strategic decisions

    With real-time visibility and notifications at the point of dispensing, your team is empowered to make quick, confident decisions about eligibility, prior auth claims, coordination of benefits claims and more.

  • Improve staff productivity

    Our solutions integrate directly into your pharmacy’s workflow, minimizing friction in the retail process and clearing paths for your team to dispense medication.

  • Help reduce audit risk

    Audit Intervention Service technology actively monitors common triggers at the point of dispense, so you can maintain prescription accuracy on the front end.

Two pharmacists reviewing information on workstation computer monitor in a pharmacy setting.

Solution spotlight: Pre- and post-editing services

Pre- and Post-Editing (PPE) Services from CoverMyMeds automates the critical elements of pharmacy claim adjudication. By providing actionable messages specific to each claim, PPE enables staff to make faster, more informed decisions that can help increase revenue and productivity.

“As a former pharmacist, I remember the computer monitors full of sticky note reminders. I’m passionate about finding ways to make pharmacists’ lives easier 
and giving them time back so they can continue taking 
on primary care. It’s exciting.”

Jennifer Wilkinson,, PharmD, former pharmacist and current CoverMyMeds Pharmacy Operations Product Manager

Join CoverMyMeds’
ever-growing network.

  • 950,000+ providers, with 350+ EHRs integrated
  • 50,000+ pharmacies, inclusive of top 10 chains
  • 650+ brands across 95% of therapeutic areas Connect with our team to see how CoverMyMeds can help deliver comprehensive solutions to improve patient access, affordability and adherence.
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