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Medical Billing

Switch to MedMe's medical billing and get paid more, faster.

End-to-end medical billing support to reclaim your team's time and maximize reimbursements. Eligibility, coding, submission, denials, and analytics in one workflow built for pharmacy.

END-TO-END REVENUE CYCLE

Five connected capabilities, one billing engine.

MedMe's RCM engine manages the full claim lifecycle, from intake to reimbursement, with built-in coding logic, eligibility verification, and reconciliation workflows. Each capability hands off cleanly to the next.

01

Patient Estimations

Predict out-of-pocket costs before the encounter.

  • Combine returned insurance benefits with fee schedules to estimate patient responsibility
  • Determine if self-pay consent or pre-service credit-card capture is required
  • Improve transparency and reduce downstream billing issues
02

End-to-End Claim Automation

Manage the full claim lifecycle, from intake to reimbursement.

  • Eligibility checks with insurer data
  • Automatic extraction of insurance card details (OCR)
  • Real-time verification of active coverage
  • Structured documentation ensures compliance upstream
03

Coding & Claim Generation

Built-in coding logic simplifies billing for clinical encounters.

  • Auto-map encounter data to CPT/ICD codes
  • Pre-populated claim templates reduce miscoding
  • Human-in-the-loop review before submission
04

Submission, Tracking & Reconciliation

Real-time visibility and hands-off denials management.

  • Live status updates for every claim
  • Automatic detection and retry of denials up to 3 times before manual review
  • Adjustment workflows for underpaid or unpaid claims
  • Reconciliation tools for complete revenue transparency
05

Dashboarding & Insights

Monitor financial performance across stores, services, and payers.

  • View claims volume, reimbursement rates, and payment timelines
  • Identify denial trends
  • Measure billing efficiency and financial return
WHAT SETS US APART

Six reasons pharmacies switch to MedMe billing.

4%

Competitive pricing, charged only on successful claims — no flat platform fee.

80%+

Reduction in manual workflows with AI assistants and PMS integrations.

98%+

Clean-claims rate at first submission across the customer cohort.

50%

Faster reimbursements than the industry average for pharmacy billing.

<24h

Claims entering processing, vs the 48–72-hour industry average.

All-in-one

MedMe's end-to-end workflow tools — scheduling, intake, documentation, follow-ups, PMS integration, billing.

THE REIMBURSEMENT GAP

Medical billing yields a 78% higher reimbursement rate than PBM billing.

For every dollar earned through PBM billing today, medical billing brings in roughly $1.78. MedMe makes that switch a workflow, not a project — with credentialing support, payer guidance, and the platform infrastructure to keep claims moving from day one.

78%
higher vs PBM billing
NEW TO MEDICAL BILLING?

We guide you through every step.

For pharmacies exploring medical billing for the first time, MedMe provides step-by-step guidance to get started — built to ensure pharmacies get paid accurately and quickly with minimal administrative effort.

Step 01

Credentialing & enrollment

Support with credentialing and enrollment for both Medicaid and commercial MCOs to unlock higher-value reimbursements.

Step 02

Expert consulting

Complimentary expert consulting on which payers and services to start with, tailored to your pharmacy's footprint and patient mix.

Step 03

Education & compliance

Education on required documentation, coding standards, and the compliance workflows that keep claims clean from the first submission.

READY TO GET PAID FASTER?

Show us a week of your encounter volume.

A 20-minute screen-share. We'll walk through your service mix, run the math live, and show you exactly which codes you're leaving on the table.

Book a demo →