The network that turns pharmacy clinical services into revenue.
Medsense holds direct Medicare, Medicaid, and commercial payer contracts in all 50 states + DC — so every pharmacy we partner with can reach more patients and earn revenue for clinical services from day one.
Contracts in place, so your pharmacy gets paid.
Payer contracts for RTM and RPM are negotiated and live across the major payers before any pharmacy program launches — not contract-by-contract, not after the fact.
We check coverage so patients say yes.
Our payer contracts let us run real-time benefit checks for every patient your pharmacy refers — surfacing copays, deductibles, and referral requirements before the first outreach call. Patients learn the cost up front, and most learn there is none.
- Real-time eligibility and benefits across contracted plans.
- Copay and deductible math, plain-English summary.
- Referral requirement flagged before enrollment.
- Zero out-of-pocket candidates surfaced first.
Medicare and Medicaid contracts in all 50 states + DC.
Wherever your pharmacy operates, the federal payer infrastructure to bill RTM and RPM is already in place under Medsense.
Open for partnership. No headaches. Built for pharmacy.
Medsense operates state medical groups that partner directly with local pharmacies through collaborative practice and service agreements. The CPA is what unlocks the clinical work: it gives our prescribers and your pharmacists shared authority to deliver, document, and earn revenue for the services patients need.
- Collaborative practice agreement (CPA) executed before launch.
- Service agreement defining scope, escalation, and revenue share.
- Coordinated care between Medsense prescribers and your pharmacists.
- Pharmacy earns revenue on every clinical encounter delivered.
Your pharmacy delivers care. We handle every claim.
Medsense runs the entire revenue cycle in-house — coding, claim submission, denials, appeals, remittance. Your pharmacy team never touches a clearinghouse. Provide the clinical service, get paid by us — regardless of whether the claim is paid or denied.
- Coding & claim submission — every program, every payer.
- Denial management and appeal workflows handled end-to-end.
- Remittance posting and clinical & financial reporting on encounters.
- Pharmacy paid on a clean monthly cadence by Medsense.