SOLUTIONS

Multilex Clinical Modules

Select an Interoperability or Government Module:

Medicaid Module™

Facilitating Medicaid drug claims processsing.

The Medicaid Module includes formulary data, and pricing information for 43 state Medicaid programs that reimburse drugs on a fee-for-service basis including published state Medicaid Maximum Allowable Costs (MACs) and Average Acquisition Costs (AAC). The module enables pharmacies and system vendors to facilitate Medicaid revenue projection, enable online pre-adjudication, billing, and processing of Medicaid claims, and avoid costly claims rejections. This drug information can be easily integrated into programmable claims administration systems, enabling fast, accurate, and efficient data processing.

FDB Medicaid Module Advantages:

  • Facilitates Medicaid drug claims processing.
  • Once integrated, permits quick access to drug formulary management indicators and billing codes indicating whether a given drug is covered by a particular state’s Medicaid program.