AnnexMedAnnexMedAnnexMed
Corporate Office
USA
299 S. Main Street
Suite 1300
Salt Lake City, UT 84111
Chennai - Tower I
CeeDeeYes Tyche Towers,
Block-1 3rd Floor, Perungudi Bypass Rd, Perungudi,
Chennai - 600096
Chennai - Tower II
4th Floor, IIFL TOWERS
MGR Main Rd,
Perungudi, Chennai - 600096
Villupuram
No 9, Viswalingam Layout
Villupuram,
Tamil Nadu – 605602

Specialty RCM capabilities

End-to-End Revenue Cycle for
Specialty & Infusion Pharmacy

AnnexMed delivers the full revenue cycle for specialty pharmacy as twelve integrated capabilities — from upstream benefit investigation through downstream patient financial counseling. Each capability staffed by therapy-trained professionals and powered by ImpactRCM.AI.

12

Integrated capabilities

98%+

Clean claim rate

24/7

Operational coverage

One Revenue Cycle, Twelve Specialty Capabilities

Specialty pharmacy revenue cycle is not a single workflow — it is twelve interconnected capabilities, each of which can break the economics of a high-cost therapy if mishandled. A misrouted benefit decision, an expired prior authorization, an unreconciled copay program, or a missed REMS documentation step each carries five-figure or six-figure consequences per claim.
AnnexMed delivers all twelve capabilities as one integrated operation, not as twelve handoffs between teams. Your specialty pharmacy operates with a single revenue cycle engine — staffed by therapy-trained professionals, governed by payer-specific playbooks, and powered by proprietary AI tuned for specialty pharmacy economics.
Explore each capability below to see how AnnexMed handles it, the typical impact, and how it connects to the rest of your specialty pharmacy operation.
Revenue Cycle-1

Schedule an RCM Assessment | Identify Revenue Gaps

Trusted by 100+ healthcare providers | AAPC, AHIMA & AAHAM Certified | SOC 2 Type II

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Why it matters

Why Twelve Capabilities, Not One Service

Most specialty pharmacy billing vendors sell a single bundled service — claims submission with denial management bolted on. The economics fall apart when a benefit investigation gets routed wrong, a hub enrollment misses a deadline, or a REMS documentation step gets skipped. These are different workflows, different skill sets, and different payer interactions, and they fail independently of each other.
AnnexMed builds each capability as a discipline with its own performance targets, its own quality assurance, and its own technology layer. Then we integrate them so your specialty pharmacy operates as a single revenue cycle — with the discipline that high-cost therapy economics actually require.

Capabilities

Benefit Investigation

Medical-vs-pharmacy benefit determination before the first claim. Coverage discovery, plan rules, formulary status, and out-of-pocket exposure resolved upstream so therapy starts without delay.

Hub Services Coordination

Centralized workflow across manufacturer hubs, patient assistance foundations, and copay programs. Status tracking, document submission, and reconciliation handled as one operation.

Manufacturer Assistance Programs

Patient enrollment, eligibility documentation, and reconciliation across pharmaceutical manufacturer foundations and bridge programs for high-cost specialty therapies.

Copay Assistance Management

Copay card enrollment, accumulator and maximizer program reconciliation, and patient assistance coordination to reduce financial toxicity and abandonment.

Buy-and-Bill Operations

Inventory-to-claim accounting for buy-and-bill specialty drugs: acquisition cost tracking, J-code billing, and reimbursement reconciliation against ASP and contract rates.

Split-Claim Billing

Single therapy episodes correctly split across medical and pharmacy benefit when payer rules require — administration on medical, drug on pharmacy, with both claims tied to the same encounter.

J-Code & HCPCS Coding

Accurate coding for specialty infusions, injectables, and unlisted drug administration. NDC-to-HCPCS mapping, unit calculations, and modifier application reviewed by specialty-certified coders.

REMS Compliance Billing

Risk Evaluation and Mitigation Strategy program documentation, certification tracking, and claim submission for REMS-restricted specialty drugs across all major REMS programs.

Denial Management

Root-cause analysis and payer-specific appeal playbooks for specialty pharmacy denials. Biologic, oncology, and rare disease appeals managed by therapy-trained specialists.

Aged AR Recovery

Recovery sweep for specialty pharmacy AR aged 90+ days. Denial re-work, secondary billing, and appeal escalation on claims most billing operations have written off.

Patient Financial Counseling

Out-of-pocket estimation, assistance program enrollment, and payment plan coordination for patients on high-cost specialty therapy. Designed to reduce abandonment and improve adherence.

Performance Analytics

Real-time dashboards covering denial trends, PA turnaround by payer, hub program performance, net collection by therapy class, and gross-to-net specialty pharmacy economics.

Built for Specialty Pharmacy Economics

Every capability is designed around the reality of high-cost therapy: large dollar exposure per claim, complex split-benefit decisions, mandatory hub coordination, and payer rules that change quarterly.

Integrated, Not Bolted Together

These twelve capabilities run on one platform with shared data, unified reporting, and a single accountable account team. No handoffs, no finger-pointing, no information loss between functions.

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Ready to See How These Capabilities Apply to Your Specialty Pharmacy?

Most specialty pharmacies identify $1M–$3M in recoverable annual revenue when these twelve capabilities are deployed as an integrated operation. Schedule a no-obligation Specialty RCM Capability Assessment.

Trusted by 100+ Healthcare Providers | AAPC, AHIMA & AAHAM Certified | SOC 2 Type II | HIPAA Compliant

Schedule a capability assessment
Request a financial impact analysis
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Payer client outcomes

AnnexMed delivers measurable financial impact within the first 60 to 90 days of engagement. The following represent outcomes from active payer partnerships:

$15M–$40M

Risk
Adjustment

$18M–$50M

Payment
Integrity

6 Weeks

Credentialing Clearance

$15M–$50M+

Revenue
Impact

Case Studies

See the impact we deliver

Discover how AnnexMed reduces denials, accelerates reimbursements, and strengthens financial performance. Backed by measurable outcomes and proven RCM expertise, we deliver operational excellence, revenue stability, and sustainable growth you can trust.

Client Voices

See how our clients succeed

Hear from organizations that trust AnnexMed to reduce denials, accelerate reimbursements, and strengthen cash flow. Our expert support delivers measurable performance gains, operational efficiency, financial stability, and scalable growth.
Claims adjudication backlogs were delaying provider payments and increasing complaint volumes. AnnexMed took over processing, cleared the backlog in 30 days, and improved turnaround by 45%. Provider satisfaction scores climbed significantly, dispute volumes dropped, and our network relationships strengthened significantly.
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Dr. Richard Calloway

Horizon Health Plan
Our payer operations team was overwhelmed with member inquiries, provider disputes, and claims rework. AnnexMed brought dedicated support that handled every function with accuracy and speed. Processing errors dropped by 60%, provider abrasion decreased, and our operational costs came down by nearly a third.
Anx Testimonial

Dr. Priya Menon

Crestview Insurance Partners
Managing claims accuracy, provider data, and member support internally was draining our resources. AnnexMed streamlined our payer operations end to end. Claims processing improved, provider onboarding accelerated, and our administrative burden reduced dramatically. They understand payer complexity like no other partner.
Anx Testimonial

Laura Simmons

Meridian Managed Care

Proven RCM expertise. Delivered at scale.

For over 20 years, AnnexMed has delivered RCM solutions nationwide, combining expert billing, coding, and AR support to drive measurable results and growth.

  • 20+ years of proven healthcare RCM experience
  • 2,000+ professionals supporting billing, coding & AR
  • 500+ certified coders across multiple specialties
  • 99%+ compliance with HIPAA and security standards
  • All 50 states served with consistent, scalable operations
Certification

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