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  6. Pharmacy benefit management - Wikipedia

    en.wikipedia.org/wiki/Pharmacy_benefit_management

    Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits. SB 966: Pharmacy benefits is a California state bill written by state senators Aisha Wahab and Scott Weiner. It is ...

  7. Express Scripts - Wikipedia

    en.wikipedia.org/wiki/Express_Scripts

    Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2]

  8. Adjudication - Wikipedia

    en.wikipedia.org/wiki/Adjudication

    The company also often sends an explanation of benefits that includes detailed information about how each service included in the claim was settled. Insurance companies will then send out payments to the providers if the claims are approved or to the provider's billing service. The process of claims adjudication, in this context, is also called ...

  9. QS/1 Data Systems - Wikipedia

    en.wikipedia.org/wiki/QS/1_Data_Systems

    QS/1 is an American software company which develops management software for pharmacies.It was founded in 1944 and is based in Spartanburg, South Carolina.. In 1977, the company recognized healthcare professionals' need for software and hardware packages designed to help provide more efficient and effective care for customers and pharmacy patients.