Managed Care

A Good Neighbor Pharmacy managed care expert shakes hands with a plan representative

Protect your independence

We negotiate contracts to maximize your profit margins while providing resources that minimize profit leakage.

Reports used to determine which plans we join at the preferred or standard cost-share level

Strategic Contracting

Reports used to determine which plans we join at the preferred or standard cost-share level
Stand united with more than 5,000 members when you join our PSAO, Elevate Provider Network. Using our proprietary pharmacy analytics system, we model and negotiate smarter payer contracts with more than 40+ PBMs based on our long-term strategy for managing the impact of preferred cost-share networks. Our data-driven approach helps us determine which plans we should join at the preferred or the standard cost-share level, and that clear objectivity helps us maximize your profit margins.
Reports used to determine which plans we join at the preferred or standard cost-share level

Elevate Provider Network

We understand that independent pharmacies need managed care solutions that work for their unique needs. That’s why Elevate Provider Network, our PSAO, crafts an optimal payer network model that negotiates the most effective contracts for your pharmacy, helping you maximize profitability, improve operational effectiveness and enhance patient care. Intuitive pharmacy analytics and our benchmarking system make your path to profitability clearer.
The Elevate Provider Network team

Protect your profits

Pre and Post Edit

Minimize your risk of making costly reimbursement mistakes by using this solution, which is like spellcheck for your claims. It automatically reviews every submission for data accuracy and applies real-time edits, so small typos never jeopardize your full reimbursement. You can even customize the edits in advance to ensure financial, administrative and legal compliance every time.

Claims Reconciliation

Avoid write-offs with our sophisticated reconciliation software, which automatically tracks every reimbursement for you and provides you with the tools you need to chase claims. We make it easy to verify your third-party payments, pinpoint underpaid claims and prevent missed checks from going unnoticed, so you can be sure you’ve collected every dollar that’s due to your pharmacy.

Central Pay

Get complete cash flow visibility so you can be sure that none of your claims have slipped through the cracks. With Central Pay, you can see when your cash is tied up in receivables or when claim errors are preventing you from getting the reimbursement you deserve. Plus, our convenient mobile app helps you stay on top of your deposits anytime, anywhere.

MAC Challenges

Have MAC challenges handled on your behalf with full visibility into your active challenges, cases with favorable outcomes and legislation pending. With more than a million claims loaded into our Pharmacy Performance system each week, we’re able to identify negative-margin MAC prices and file all applicable claims for you, saving you time and maximizing your reimbursement.

Get in touch

At Good Neighbor Pharmacy, our expert team is aligned in its commitment to your needs and the interests of independent pharmacies across the United States. Want to know more about how Good Neighbor Pharmacy can amplify your brand, simplify your business operations and protect your independence?