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solutions: health plan

claims processing

Superior-quality claims processing is at the heart of Argus' business. Since 1986, we have combined world-class information services with the expertise of dedicated healthcare and technology professionals to continually improve the quality and accuracy of our claims processing service.

The Integrated Pharmacy Network System (IPNS®) is Argus' proprietary, database-managed software for pharmacy claims processing. The comprehensive design of IPNS allows real-time online inquiry and update access to all data elements involved in the processing of pharmacy claims.

Argus accepts batch electronic, paper, and POS claims from pharmacies and mail-order facilities across the country. All claims are adjudicated through IPNS. Argus relies on this tested and proven system as the core of its comprehensive package of pharmacy benefit capabilities.

Our system's flexibility allows us to support virtually any benefit design. We process approximately 13 million claims per month, spanning 270,000 separate plans—each plan representing a unique combination of drug coverage, reimbursement rates, and processing parameters.

Although we maintain a fully customizable system, providing accurate, quick transactions is an ongoing objective. Argus performs roughly 150 edits on each submitted claim in an average of less than a second.

We understand that the ability to process claims impacts your bottom-line. The Argus system is available for pharmacies to submit claims 24 hours a day, seven days a week, with the exception of scheduled maintenance.

Argus' robust and powerful technology provides claims processing that is fast, accurate, and dependable—translating to member satisfaction at the point of sale. With Argus as your Pharmacy Benefit Partner, you are assured the superior solutions and quality service necessary to accomplish your business goals.

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