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Pharmacy Operations

Structured Workflow Governance for Pharmacy Scale

Pharmacy Operations

Optimized for Pharmacy Scale

Pharmacy operations demand speed, accuracy, and regulatory discipline. At IRIE Global, we embed structured workflow governance into every pharmacy engagement, replacing fragmented inbox management and manual tracking with centralized queue orchestration and real-time SLA monitoring.

Through AI-assisted inbox classification and rule-based prioritization, refill requests, PA forms, and clinical inquiries are automatically categorized and tracked ensuring zero missed actions and complete visibility.

Cycle Billing Optimization

Cycle Billing Optimization

We manage recurring billing cycles with automated payer-rule validation, eligibility verification, and systematic pre-submission error checks. Clean-claim discipline is built into the process — not reviewed after rejection.

Key Activities Include

Clean claim validation and payer-rule enforcement
Accurate patient and responsible party billing
Proactive eligibility and coverage verification
Systematic pre-submission error checks

Impact

Increased first pass claim rate
25% improvement in clean claim submission rates
30% faster recurring billing cycle completion
Reduced outstanding balances
Faster reimbursement cycles
Lower billing rework
Denial Management

Denial Management

Rather than reacting to denials individually, IRIE deploys structured denial categorization and root-cause intelligence loops. Repeated BIN/PCN mismatches, NDC conflicts, missing PA documentation, and physician data errors are tracked and analyzed to prevent recurrence.

Key Activities Include

BIN/PCN validation
NDC and drug mismatch correction
Missing PA and physician detail resolution
Root-cause analytics to prevent recurrence

Impact

Reduced revenue leakage
Accelerated payment turnaround
Strengthened compliance
30–40% reduction in repeat denial categories
Mobile Orders Processing

Mobile Orders Processing

Structured management of orders received through mobile platforms, apps, and remote channels.

Key Activities Include

Prescription validation
Drug availability verification
Patient communication coordination
Fulfillment accuracy assurance

Impact

Reduced fulfillment errors
Improved patient satisfaction
Enhanced order visibility
Inbox & Refill Workflow Orchestration

Inbox & Refill Workflow Orchestration

At IRIE, inbox management is not a sorting task — it is a governed workflow. Every inbound request is timestamped, SLA-tracked, and escalated if necessary.

Key Activities Include

Sorting and prioritization of refill requests
PA form processing
Clinical inquiry routing
Physician follow-ups
New Patient Entry
Vaccination billing / Entry

Impact

Zero missed requests
Improved medication adherence
Reduced care gaps
>98%+ SLA adherence on inbox turnaround
99.8% refill request tracking (zero missed actions)
<0.5% audit documentation error rate
Pharmacy Helpdesk Support

Pharmacy Helpdesk Support

By integrating centralized dashboards and structured documentation protocols, we enable high first-contact resolution while maintaining audit-ready compliance logs.

The result is improved patient experience without compromising operational control. High-quality, structured support for patients, caregivers, and providers

Key Activities Include

Medication inquiries
Copay clarification
Delivery tracking
Prior authorization updates

Impact

Improved first-contact resolution
Enhanced patient experience
Average talk and handle times well below benchmarks
Call abandon rates below 0.30%
Average wait times under 11 seconds
Shrinkage maintained below 5%

Optimized for Pharmacy Scale

We ensure zero missed actions and complete visibility across your entire pharmacy back-office ecosystem.

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