Questions, answered

New York and New Jersey today, with more coming. We would rather tell you plainly that you are outside our footprint than take the work and learn a new state on your claims.

The carrier, the claim number, the adjuster and the date of loss, plus the assignment of benefits. Confirming those before the fill is the single highest-value thing in this whole business: a script filled against a claim that does not exist is a write-off, and no amount of follow-up afterwards changes that.

Yes. The NF-3 for New York No-Fault and the Attending Provider Treatment Plan for New Jersey PIP are prepared and submitted as part of the daily cycle, with the dispensing detail the carrier will ask for already attached.

The denial is read rather than filed. Some are fixable and get corrected and resubmitted; some are a carrier declining to pay a payable claim, and those get an arbitration packet. What does not happen is a denial going into a folder.

The pharmacy dispenses against a personal injury settlement and is paid when the case resolves. We paper the lien or letter of protection with the attorney up front, keep a per patient and per case ledger, keep the status current with the firm, and present the balance at settlement with the dispensing record behind every line. An unpapered lien is an unpaid one.

Not yet. It is on the way and it is listed on the home page as coming soon rather than as something we do. Until it is live, claims go out the way each programme actually accepts them.

Independent retail pharmacies, small and mid-size groups, specialty pharmacies, and long-term-care and closed-door pharmacies. The common thread is accident and injury work: if you are filling for a No-Fault, PIP, lien or workers' compensation patient, that is the book we run.

Yes. We work inside the system you already run: PrimeRx, BestRx, Rx30 and the other common platforms. We adapt to your existing clearinghouse and payer setup. Nothing is migrated and your staff do not learn new software.

No-Fault in New York, PIP in New Jersey, personal injury liens, and workers' compensation in both states. They follow different rules from a retail claim, they are where independents most often leave money behind, and they are the whole reason this company exists rather than a line on a longer list.

Yes. Benefit verification, opening and submitting the authorisation, chasing the prescriber's office for documentation, and tracking it to a decision. Renewals are tracked before they lapse, which is the failure that turns an approved therapy into a rejected refill.

Yes, and it is a common arrangement: your in-house person keeps the retail day-to-day and we take the accident book, the AR backlog or the denials, which is the work that never gets to the top of the pile.

Yes. The same billers work your account and learn your payer mix, your prescribers and your exceptions, with a named lead you can call. Accounts are not rotated through a general queue.

Yes, and before any access is granted rather than after a pilot. Working your claims means handling protected health information, so the BAA is part of getting started, not part of the paperwork afterwards.

Access starts only once the Business Associate Agreement is signed, and it is limited to what the work needs. Ask us what we hold, where it is kept and who can see it, and you get a straight answer before you sign anything.

Rx Billing Inc is a US company and your account is handled by our own team. We will tell you who is working your account and from where. Ask, and you get a straight answer.

Your data is yours. When an engagement ends, our access to your systems is removed and you get a documented handover of open claims and appeals in flight. What happens to any records we hold is set out in the Business Associate Agreement you sign with us.

Pricing depends on your claim volume, your payer mix and how much of the cycle you want us to run, so we quote it after looking at your numbers rather than listing a rate that would be wrong for most pharmacies. Ask and we will tell you plainly what your situation would cost.

It depends on how quickly access and the BAA are in place on your side. That is usually the long pole, not our setup. We will give you a date once we have seen your systems, and we would rather name a real one than a comfortable one.

Rejections handled the same day change within the first cycle. Aged AR is slower, because a ninety-day claim is harder to collect than a five-day one, which is exactly why it is worth working. We report what moved rather than asking you to take it on faith.

Yes, and it is one of the most common reasons a pharmacy calls. We work it highest-value first alongside current billing, so today's claims do not fall behind while yesterday's are being recovered.

No minimum volume. Terms are something we agree with you rather than something you inherit. Tell us what you need and we will tell you whether it works.