Pharmacy Software

Pharmacy Software Features

Software Features

PioneerRx is the most powerful, customizable, and intuitive retail pharmacy software. Explore our comprehensive feature set below, then visit the Pharmacy System page to learn more about our mobile apps and other technology integrations.

MTM / Adherence

Improve patient outcomes by tracking and coordinating your patients' medications in your pharmacy software with built-in features for Adherence, Patient Risk Scores, MTM, Med Sync and more.

Do you want to increase patient adherence and compliance? With the help of PioneerRx Pharmacy Software’s top-notch programs and features, you can potentially boost your pharmacy’s CMS Five Star Rating by increasing patient adherence. Only the best pharmacy software companies are tracking this directly within workflow.

Five-Star Program

The Center for Medicare and Medicaid Services (CMS) aims to provide better care, healthier people and communities, and lower cost care. In alignment with this goal, CMS developed a one to five star rating system used to evaluate the performance of Medicare Advantage plans. A plan’s star rating is significant because it directly affects their compensation and marketing advantages.

Medicare Advantage plans are rated on performance areas, including outcome measures (improvement in health), intermediate outcome measures, patient experience, access measures (barriers to care), and process measures (how care is provided).

Part D plans are rated on performance measures for four domains: Drug Plan Customer Service, Member Complaints, Problems Getting Services, and Choosing to Leave the Plan, Member Experience with Drug Plan, and Drug Pricing and Patient Safety. The Drug Pricing and Patient Safety domain includes Pharmacy Quality Alliance (PQA)-supported medication adherence measures.

CMS also uses Display Measures to further evaluate Part D plans. Although not included in the plans’ star ratings, these evaluations are reported to CMS and are displayed on the “Patient Safety” website. PQA-supported measures of medication safety, including drug-drug interactions, excessive doses of oral diabetes medications, and completion rate of Comprehensive Medication Reviews, are measured and reported. This is where pharmacies come in!

Data is collected detailing pharmacies’ performance in areas such as vaccinations, health coaching, medication therapy management, health promotion, care coordination, and adherence counseling. Medicare Advantage plans are particularly focused on medication adherence for Part D patients receiving maintenance medications for diseases, such as diabetes, hypertension, and cholesterol.

Pharmacies’ performance evaluations could potentially determine whether a Medicare Advantage plan includes a pharmacy in a preferred network. Plans may seek pharmacies who support their goals and who are willing to work to boost their performance numbers, such as those related to medication adherence.

For pharmacies, this may be a prime opportunity to collaborate with Medicare Advantage plans to improve star ratings and ensure patients are receiving appropriate care. The landscape of healthcare is evolving. In the future, pharmacies will play a growing role in providing comprehensive healthcare to their patients. We recommend you learn more about the CMS star-rating system and how your pharmacy is being evaluated.

Enhanced Workflow

Our customizable and intuitive workflow allows you to run your pharmacy in the way that works best for you. By making processes more efficient, you are able to do more for your business and your patients.

IVR

Interactive Voice Response (IVR) is an effective solution for reducing bottlenecks in workflow caused by time spent on the phone. IVR frees up your staff from repetitive phone calls about topics like general pharmacy information, prescription refills, and prescription status. By including an IVR solution in your pharmacy, you can automatically route phone calls to save time, reduce interruptions, and even send customized outbound messages.

MedTel IVRx is a cloud-based solution that seamlessly integrates into PioneerRx Pharmacy Software, enabling you to automate prescription refills, send outbound notifications, customize auto-attendant settings, and route phone calls. MedTel can scale to fit the size of your business and your unique needs, and it integrates into your workflow to help you run your pharmacy more efficiently and elevate your patient experience.

Central Office

If you have multiple pharmacy locations, it may feel like you’re constantly trying to be in two (or more) places at once. With the Central Office capability, PioneerRx users can access all of their stores’ data at any time. Manage all of your reporting, dispensing, pricing, patient profiles, accounts receivable, prescriber information, and other data sharing between all of your locations with ease.

Inventory & Ordering

Having a well-managed inventory is the foundation of a successful pharmacy business. Automate ordering and manage even the most complicated inventories with ease.

Finance & Reporting

Don't miss out on opportunities to improve your bottom line. PioneerRx Pharmacy Software features robust reporting to give you insights into every aspect of your business.

From the start, PioneerRx Pharmacy Software changed the game when we became the first pharmacy software system to provide integrated Pre/Post Edit functionality. These Edits are designed to save your pharmacy money and prevent mistakes from walking out the door. Since both of these are important to your success, PioneerRx has included these feature at no extra charge. While other software vendors sometimes offer this service with claim switching, you may be charged as much as seven cents per fill, which quickly adds up.

PioneerRx’s Pre/Post Edit solution allows you to fill with speed, efficiency and the peace of mind of knowing that costly errors can be addressed and prevented before it’s too late.
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‍Pre-Edit is an evaluation of the prescription data before it is sent in order to determine items that need to be corrected.
‍Post Edit is an evaluation of the claim data after it is adjudicated. You decide whether to reject, review, or ignore each type of Rx Edit issue.

Here are some examples of how you can use Pre/Post Edits in your Pharmacy.

Base Limited - Post Edit
Pharmacy contracts are typically based upon AWP – X% + Fee or MAC + Fee. The no-fee version (underlined) is called the Basis. If a pharmacy transmits a claim with a basis less than their contract, the third party will typically pay the reduced amount. If this occurs, a Basis Limited post edit will be triggered.
With PioneerRx you can make more money by finding and correcting pricing mistakes that cause Basis Limited claims.
Cash Limited - Post Edit
‍Pharmacy contracts typically limit reimbursement to the minimum of the contracted amount or the pharmacy’s Usual & Customary (Cash) price. The Cash price is transmitted with the claim. If this limits the third party payment, a Cash Limited post edit will be triggered.
Use this handy post edit to find and correct pricing mistakes that cause Cash Limited claims.

DAW Code - Pre/Post Edit
‍If a generic is available and a brand is dispensed without a reason provided, many pharmacy contracts will reduce reimbursement to the contract amount for the generic. Dispensing a brand when a generic is available will trigger a DAW Code pre/post edit, if a DAW code isn’t selected.
‍One Texas pharmacy converted to PioneerRx and found that they had been being cut back $800 per fill on a drug in their previous system due to this issue. PioneerRx found the problem, and they were able to fix the prescription.
Package Size - Pre/Post Edit
‍If an item that should not normally be broken down (Vial, Tube, etc) is filled with an incompatible dispensed size, Package Size pre/post edits are triggered. Filling with the wrong size can cause a significant loss of profit and possibly trigger an audit.
The average pharmacy makes an additional $100-$400 a month when these errors are corrected.

Third Party Remitted a Negative Amount - Post Edit
‍Some third party plans are simply discount plans with 100% copay. Many charge the pharmacy for the privilege of accepting this plan. The third party sends the pharmacy a bill for these amounts. If a prescription returns a negative remitted amount where the pharmacy would owe a third party for filling a script, a Third Party Negative Remitted Amount post edit is triggered. Then, simply switch the prescription to cash or another discount plan that does not include a negative remitted amount.
Avoid paying unnecessary third party fees.

‍Obsolete NDC - Pre/Post Edit
‍If an item is dispensed with an expired NDC, a pre/post edit is triggered. Inadvertently using a wrong or expired NDC could reduce your reimbursement and possibly trigger an audit.
By using this Rx edit, you could be preventing obsolete NDCs from ever being submitted.

‍Dispensing Item Out of Stock - Pre/Post Edit
‍Keeping a perpetual inventory is a challenge with some pharmacy software due to the dispensed item changing on refills. PioneerRx makes it easy with Dispensed Item Out of Stock pre/post edits.

‍Low Profit - Post Edit
‍If the gross profit on a prescription is less than the minimum percent or dollar value set by the pharmacy, a Low Profit post edit will be triggered. In addition, Smart Profit Reject allows the pharmacy to include consideration of rebates and the last cost paid for the item before prompting a Low Profit post edit.

‍Patient ID Missing - Pre/Post Edit
‍If patient identification, such as a driver’s license or social security number, is required due to the schedule of the dispensed item and it has not been entered, Patient ID Missing pre/post edits are triggered.

‍Patient Information Missing - Pre/Post Edit
‍If the patient’s allergy, other medications, and/or medical conditions are missing or out of date and a prescription is filled, Patient Information Missing pre/post edits are triggered.

‍Missing or Invalid DEA - Pre/Post Edit
‍If a prescriber with a missing or invalid DEA is attached to a prescription, and the DEA number is required due to the dispensed item, Missing or Invalid DEA pre/post edits are triggered.

‍High Copay - Post Edit
‍The pharmacy can define a high copay amount in location options. If a copay is higher than the amount defined, the pharmacy may choose to verify that the patient wants the item before it is filled. If a claim is adjudicated with a copay that exceeds this amount, a High Copay post edit is triggered.

‍Higher Secondary Copay - Post Edit
‍If the secondary third party returns with a higher copay amount than the primary, a Higher Secondary Copay post edit is triggered. Misconfigured coupons or third party settings typically cause this error.

‍Missing or Invalid DPS - Pre/Post Edit | Texas
‍If a prescriber with a missing or invalid DPS is attached to a prescription, and the DPS number is required due to the dispensed item, Missing or Invalid DPS pre/post edits are triggered.

Integrated Point-of-Sale

When we say fully integrated Point-of-Sale, we mean it. Not only can you complete patient transactions, you can also be alerted about potential interventions, see other medications in queue, track patient loyalty status, and more.

Compounding

Manage your compounding directly within workflow. Keep track of compounding inventory, accurately price medications, and properly bill for maximum reimbursement.

Long Term Care / Facility

Extend your reach beyond your pharmacy. Streamline cycle filling, manage facility billing, and generate custom MARs and physician orders based on each facility's unique needs and structure.

Security & Support

More than anything, PioneerRx Pharmacy Software customers love their dedicated support team. Each pharmacy is assigned a support team made up of certified pharmacy technicians, accounting specialists, and hardware support.

At PioneerRx, our primary goal is to help your pharmacy be successful by using our software. To reach your pharmacy’s top potential, you need full access to the proper resources. PioneerRx provides ongoing assistance, beginning with thorough training at point of installation and extending to personalized software support for the duration of usage. At PioneerRx, we value your time and understand the importance of urgency and efficiency within the pharmacy; therefore, we strive to deliver speedy response times for all types of questions, requests, and concerns. Our knowledgeable team of support personnel includes:
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Software Support
‍Upon going live with PioneerRx software, each pharmacy is assigned software support who will provide one-on-one troubleshooting and assistance. With an average of over 10 years of pharmacy experience as licensed pharmacy technicians, our software support can relate to the oftentimes hectic and stressful atmosphere of the pharmacy and can appreciate the need for prompt call-backs. Over time, our software support will become familiar with your daily schedule and your pharmacy’s business. He/she will note which areas of the software you struggle with most and make recommendations accordingly. Support support provides your pharmacy with the most effective troubleshooting and guidance through software issues. All software support attend regular meetings to keep them informed of any software updates. Armed with a strong pharmacy background and comprehensive knowledge of the PioneerRx software, your software support will become an invaluable resource for your pharmacy and is accessible at the click of a button.
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‍Hardware Support
Our expert Hardware Support team aims to resolve any and all of your PioneerRx hardware-related issues. Once a pharmacy submits a hardware-related call request to PioneerRx, it is directly assigned to one of our highly-qualified technical support representatives, who will diagnose and rectify the issue for your pharmacy. With solid backgrounds in information systems and PC repair, our skilled Hardware Support members can readily troubleshoot issues and guide you through a solution to the problem.
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‍Accounting Support
‍Accounting Support Services is comprised of our specialized staff that specifically handles PioneerRx accounting questions and calls. The qualified team assists pharmacies with everything from financial research and reporting, pricing, customer A/R accounts, point of sale, inventory, Third Party reconciliation, taxes, credit card reconciliation, and so much more. Backed with an Accounting degree or a CPA, our experienced Accounting Support Team is capable of answering any questions or concerns which focus on your pharmacy’s bottom line.

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