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

Hospice & Closed-door Services

Specialized Billing for Hospice, Correctional,
PACE & LTACH Pharmacy

Closed-door pharmacy operations sit outside the rules retail and LTC billing operations are built for. AnnexMed delivers ten specialized services across hospice election routing, Part A coverage, PACE capitation, correctional billing, and LTACH institutional pharmacy — built on contract-specific operational expertise.

HOSPICE

Election validation

99%+

Part a routing accuracy

ALL

Closed-door models

Closed-door pharmacy lives outside standard billing rules

Hospice pharmacy, correctional pharmacy, PACE programs, and LTACH operations each run on payment models that don’t fit retail or standard LTC billing workflows. Hospice election triggers Part A overrides that pharmacies routinely miss. Correctional pharmacy runs on capitation. PACE operates as full-risk integrated care. LTACH mixes inpatient institutional billing with behavioral health and substance use reimbursement.

AnnexMed delivers closed-door pharmacy operations as ten specialized services, each built around the specific contract model, payment logic, and operational reality of the setting. The same team handles hospice election validation, PACE capitated reconciliation, correctional chargeback, and LTACH institutional billing — with operational expertise that generalist pharmacy billing vendors don’t have.

Explore each service below to see how AnnexMed handles it, the typical impact, and how it integrates with your closed-door pharmacy operation.
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Trusted by 100+ healthcare providers | AAPC, AHIMA & AAHAM Certified | SOC 2 Type II

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Why it matters

Why closed-door operations need closed-door expertise?

The mistakes that cost closed-door pharmacies the most money aren’t billing mistakes — they’re coverage and contract mistakes. Misrouting a hospice patient’s claims to Part D for three months. Missing a PACE capitation reconciliation against actual drug spend. Failing to apply correctional facility contract pricing to claims. Not catching an LTACH discharge that should have transitioned billing to a different payer.
These failures don’t show up in standard pharmacy billing audits because the claims look clean. They show up in margin erosion that takes quarters to identify and even longer to recover. AnnexMed runs closed-door pharmacy operations with the contract literacy, coverage routing discipline, and operational visibility required to prevent these failures in the first place.

Hospice & closed-door services

Hospice Election Validation

Pre-fill validation of hospice election status to route Part A coverage correctly. Prevents the misrouted Part D and Medicaid claims that pharmacies routinely absorb as write-offs.

Part A Coverage Routing

Accurate Part A vs. Part D vs. Medicaid routing logic for hospice patients. Coverage determination at point of dispensing, retroactive adjustment workflow, and reconciliation against hospice provider relationships.

Hospice Cap Calculation

Hospice aggregate cap and inpatient cap tracking, reconciliation, and reporting. Monthly cap utilization monitoring with proactive alerts when patients approach cap thresholds.

Correctional Pharmacy Billing

Closed-door pharmacy billing for state and federal correctional facilities. Capitated and per-script reimbursement models, specialized chargeback workflows, and contract-specific billing protocols.

PACE Program Billing

Pharmacy operations support for Programs of All-Inclusive Care for the Elderly. Full-risk capitated payment reconciliation, integrated care coordination billing, and PACE-specific reporting.

LTACH & Behavioral Health Billing

Specialty institutional pharmacy billing for long-term acute care hospitals, inpatient psychiatric facilities, and substance use treatment centers with mixed Medicare, Medicaid, and commercial reimbursement.

Closed-Door Operations Support

Full operational support for closed-door pharmacy models: census reconciliation, contract billing protocols, facility integration workflows, and capitated payment management.

Contract & Chargeback

Facility contract billing across capitated, per-diem, and per-script models. Wholesaler chargeback reconciliation and recovery on contract-specific inventory and pricing arrangements.

Census Reconciliation

Daily and monthly facility census reconciliation against billed claims. Catches gaps in patient enrollment, discharge status, and transfer events that drive billing errors in closed-door operations.

Patient Census Updates

Active patient census update workflow with facility business offices and clinical staff. Admission, discharge, transfer, and hospice election updates synchronized to pharmacy billing in real time

Election Routing Done Pre-Fill, Not Post-Denial

Hospice election validation happens before dispensing, not after the denial arrives. Part A vs. Part D vs. Medicaid routing decisions are made on accurate election data — eliminating the write-offs pharmacies routinely absorb on misrouted hospice claims.

Built for Capitated & Contract Reimbursement

PACE capitation, correctional contract billing, and LTACH institutional reimbursement each operate outside standard NCPDP retail logic. Our team manages all three with the contract-specific operational expertise these models require.
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Ready to stop absorbing hospice and closed-door billing losses?

Most closed-door pharmacy operations identify $300K–$1M+ in recoverable losses from misrouted hospice claims, missed PACE reconciliation, and unrecovered contract chargebacks in their first assessment. Schedule a no-obligation Closed-Door Services Assessment.

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

Schedule a closed-door assessment
Request a hospice recovery analysis

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.
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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.
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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
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