In today’s pharmacy environment, every claim counts. With growing prescription volumes, increasing complexity in reimbursement rules and staff constantly balancing clinical and administrative duties, there’s little room for inefficiency — especially when it comes to claims management.
That’s why ARC, a relatively new but rapidly growing pharmacy claims tool, is changing how pharmacies across Ireland handle claims, reclaims and rejections — all in real time, with minimal disruption to workflow.
When I was asked if I would write an article for the IPN, Arc was
the obvious choice for me.
With more than 25 years
in pharmacy in Ireland, I have seen the administrative burden grow so much and I am delighted to recommend Arc to help
prune it back to a far more manageable size.
When I was first shown Arc, it was kept exclusively for a buying group; I saw enough to know that I did not want to know more unless I could have it.
A year on, I happened to sit next to Alan from ARC in an IPU meeting and discovered it was now accessible outside the buying group. With Alan’s help and senior management on board, we rolled this out to our stores. Feedback has been wonderful and it’s only likely to get better.
Live Claims Support Right at the Point of Dispensing
At its core, ARC is claims intelligence software that quietly sits alongside your dispensing system. It monitors prescription entries as they happen and raises alerts when an issue is likely to trigger a rejection from PCRS. It identifies and assesses each claim with pinpoint accuracy and alerts using the PMR (Patient Medical Record) file number to adhere to GDPR demands.
From identifying second supplies of items like Dexcom sensors, to flagging 777 coded or prior approval only items, ARC proactively reduces the risk of costly claim rejections.
These alerts allow pharmacy staff to make corrections before the claim is submitted — a game-changer in reducing unnecessary rejections. Better still, if an alert isn’t relevant or concerning, it can be dismissed. When a patient record is corrected the alert resolves automatically.
Not only does this save time on backtracking and reprocessing claims, but also serves as an excellent training tool for newer technicians — essentially training while dispensing.
Digging into the Past: Smarter Rejection Management
ARC goes beyond the current claim. It also helps pharmacies take control of historical claims and payment issues by pulling in data from payment books and meticulously crosschecking GMS and DPS payment reports against submitted claims — line-by-line, item by item.
Any rejected or unpaid claims are flagged; the reason for rejection is provided, and any action taken—such as resubmission or contact with the HSE—can be logged using ARC’s built-in notes feature.
This gives pharmacies full visibility into where they are losing money — and how to get it back.
Pharmacy teams can easily review past claims for the same patient or item to check payment history, which reduces duplicate effort and provides valuable context for handling repeat rejections. If a claim is eligible for resubmission—either online or manually—ARC automatically reconciles it once payment comes through. Where no recourse is possible, pharmacy staff can reconcile the rejection manually or create a new claim
as necessary.
For unrecoverable rejections, ARC allows for manual reconciliation or the creation of a new claim for proper coverage. Even methadone dispensing is included: the system pulls in methadone book data and flags any rejects for reclaim.
Reducing Workload, Increasing Clarity
ARC is designed with simplicity and efficiency in mind. Beyond claims and reclaims, it handles time-consuming admin tasks that can burden busy pharmacy teams.
The platform keeps track of Hardship Scheme claims and payments, enabling easy cross-referencing and reducing time spent chasing down payment confirmation. It also compiles a list of patients eligible for High Tech patient care fee-only claims, ready for processing at the end of each month, streamlining one more administrative task that would otherwise take up valuable hours.
All of this helps cut down on spreadsheet report checks, duplication of work, and paper trails — freeing up your team to focus on patients, not paperwork.
Powerful Oversight at the Group Level
For pharmacy groups, like us, ARC offers even more. It is real-time claim and reclaim tracking at the branch level gives head office a clear view of what is happening on the ground.
Head office teams can view claims and reclaims in real time, complete with reject and reconciliation notes regarding follow-up and branch level performance trends.
This kind of oversight not only helps with auditing and compliance but also makes it easy to spot trends, identify recurring issues and provide targeted support to specific branches, enabling faster decisions and more coordinated follow-up.
This enhanced visibility ARC provides actual financial values of rejections and reclaims, enabling more accurate forecasting and financial planning.
A Proven Impact: The ARC Experience
We adopted ARC across our 13 branches — and the impact has been significant.
We have seen a clear reduction in rejections across the group. ARC has made it easier for our teams to spot issues before they become problems. Following up on outstanding claims is now faster, easier and more structured. We no longer rely on PCRS percentages to understand store performance — we can now put financial value on both rejected claims and reclaims.
In a sector where margins are under constant pressure that kind of clarity and control is invaluable.
The Team
It’s not just a game changing product.
The team behind ARC are huge support, with training, guidance and problem solving just the tip of their iceberg of talents.
They can also put up with me and my teams endless suggestions.
Conclusion: Taking the Stress Out of Claims Management
Whether independent or part of a group, ARC offers a smarter, simpler way to manage claims, reduce rejections, and regain control of lost revenue. It’s more than just a claims tool — it’s a complete claims strategy, built for the realities of today’s pharmacy.
Written by Sarah Gilson,
Dispensary Support Manager, Adrian Dunne Pharmacies
Read our Latest News HERE
Read IPN May HERE
