5 things about Pharmacy Billing & Re-Imbursements
Are
you a physician with multiple offices? If the answer is yes, it is good to
dispense medications directly from your practice. It will add to your source of
additional revenue and also offer a welcome convenience to your patients.
As
the healthcare sector works in an ever-changing domain, dispensing medications
from your practice can prove to be a bit complicated. However, if you want to
try dispensing medication as a part of your practice, you need to understand
every process involved. Learning about these procedures will also help you get
familiarized with various options that can simplify the dispensing medication
process for you.
Let’s
have a quick look at the 5 considerations about the billing and the
reimbursement for dispensing medications from your pharmacy practice:
Optimal Data Workflow
It
is essential to know how pharmacies balance their revenue with the expenses and
bill their claims. This will help you maintain a sustainable dispensing program
for your practice and keep the avenues of growth open for your pharmacy
business. Moreover, ensure that the entire process is controlled and monitored,
starting from procurement to inventory, storage to dispensing, and finally
closing the revenue cycle with proper and accurate billing and reimbursement.
All the information needed to handle the process must also be entered
accurately to avoid errors that can create costly and time-consuming denials.
Compliance, Rules,
and Regulations
The
most volatile space in terms of standards and legalities is the healthcare
sector, especially anything that involves medication. Unless you are not up-to-date
with the constantly changing drug-related CMS regulations, you pose a risk of
being non-compliant in your practice. This can also result in a denial of
reimbursement by the payers. To avoid such a concern, pharmacies must follow
the present CPT (Current Procedural Terminology) codes assigned for performing Medication
Therapy Management (MTM). It is also crucial to include the NPI for both the
pharmacies and the prescribers on all the claims.
Procurement
Procurement
is the level where the information moves from referring to purchased quantities
and the pricing for the same that denotes the storage units of measure (UoM)
and the inventory costs. Mostly, the data is entered manually. In fact, the
figures uploaded from the wholesale distributors to the pharmacy system are
also checked manually to avoid errors. This is because the potential source of
mistakes is data transfer that can impact the revenue
cycle management.
Coding
Another
point of attention required to eliminate the occurrence of costly errors is coding.
Make sure that drugs have appropriate HCPCS coding and should be adequately
represented in the chargemaster ; otherwise, it will lead to no or low reimbursement.
These are pharmacy charge description master, a starting point for the medical
billing of payers and patients. The key is to convert the quantities of the
pharmaceutical from purchased amounts to patient-monitoring quantities.
The linkage between Billing
& Purchases
There
are different processes in the hospitals for ordering, administrating, and
reimbursement procedures for the drugs. In such a scenario, pharmacies within
the hospitals are usually called upon to reconcile the links between the drug
expenses and the chargemaster. But this creates a scope for improper
reimbursement. Instead, having a system that can simplify the entire process of
medication dispensing operation can be of great help.
Moreover,
patients would find it more convenient to obtain their medications directly
from their physicians. This will not only save their trip to the pharmacy but
also assured them of timely handling of their queries. When you have an
efficient pharmacy
billing and
reimbursement practice, you can make your healthcare practice more profitable
and a great source of revenue.
Simplify your
Practice’s Medication Dispensing with 24/7 Medical Billing Services!
Safeguarding
the medication dispensing operation of your healthcare practice from all kinds
of complexities is the key to your practice’s viability that can impact the
revenue cycle. 24/7 Medical Billing Services can help you with a simplified
medication dispensing procedure that can make your practice more efficient and
effective. Don't forget to contact our experts for outsourcing
pharmacy medical billing and coding activities, keeping in mind the considerations about
the reimbursement.
About
24/7 Medical Billing Services:
We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.
24/7
Medical Billing Services
Tel
: +1 888-502-0537
Email:
info@247medicalbillingservices.com
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