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Pharmacy Billing Services Florida, FL

Pharmacy is an integral part of healthcare, and, just like other disciplines of healthcare, it also poses certain billing challenges that may often be difficult to manage internally. Moreover, because certain drugs are excluded from insurance coverage and only a few injections and adjuvant therapies allowed, it may require experts to judge the efficacy either including or excluding the drugs during billing.

To complicate matters further, pharmacy-related reimbursements require multiple levels of data handling and follow-ups as in most cases. Although it is a separate set of medical service and provided from a separate facility, claims are prepared and submitted together by hospitals or nursing homes – either because they come later in the care chain or because it forms a small part of the care services hospitals provide. This joint-claim preparation and submission leads to greater potential for inaccurate Data handling and denied claims.

Our Florida billing service can help you to increase your revenue with the reduction in the number of denied and unpaid claims. Our billers present in all the major cities like Jacksonville, Miami, Tampa, St. Petersberg and Orlando can provide you with less paperwork and more accurate medical claims to improve the efficiency of your practice. Here are some of the services which our billers have shown their proficiency in:

  • Claims are processed on the same day
  • Analysis of accounts receivables
  • Weekly as well as monthly reports on productivity
  • Analysis of codes and procedures on a regular basis
  • Review of fee schedules for updates

Our billers in Florida have been tracking the rate of reimbursements which has been dipping in the state past a decade. They also have analyzed the solution to this dip, the answer lies in the state of Florida’s reimbursement statutes itself. These local Florida billers are the key to unlock blocked cash flows and can provide you with updated methods to improve the efficiency of your practice.

Value Our Florida Billers Bring:

The Florida medical billing and coding services that we provide are not just limited to cities such as major cities like Jacksonville, Miami, Tampa, St. Petersberg and Orlando. They also extend to almost all other towns and smaller cities in Florida. These medical coders and billers surpass HIPAA compliance and are also trained in preferred language such as Spanish. They have been recommended in their past engagements for their medical billing administrative skills, excellent Data Entry management, along with good written and oral communication skills.

Our medical billers and coders in Florida at medicalbillersandcoders.com perform specialized tasks such as reviewing encounter forms for accuracy in ICD-10 and CPT coding, maintain records of existing billing and coverage rules, posting charges and payments to accounts, make follow up calls to insurance companies to resolve any inconsistency in payments and to patients whose accounts were past due to set up a payment plan, report to physicians regularly, offer customer support by comprehending and elucidating insurance EOBs, co-pays, co-insurance and deductibles to patients and enter and revise patient demographics.

Our Specialties:

Florida medical billing specialists can not only assist in increasing your income but also guarantee suitable reimbursement, provide medical billing and coding services in specialties including Otolaryngology, Primary Care, Optometry, Family Practice, Hospitalist Billing, Cardiology, OB Gyn, Physical Therapy, Pediatrics, Internal Medicine, and Dental.

Our Software Experience:

Physician shortage would always be a problem in Florida and is not only affecting doctors but also bigger hospitals, hospices, nursing homes, nurses and resident doctors. The shortage would mean long working hours and more accurate medical coding and billing practices. However, implementation of EMRs is proving to be of immense help since most of the paperwork is diminished and doctors have real-time information about patients and other related data. Our coders and medical billers are expert in software such as Medisoft, Misys Tiger, Eclinicalworks, Advance MD, GE Centricity, and Altapoint.

Difficulties & Challenges Florida Physicians Face:

One of the unique challenges that physicians and healthcare provides face in Florida is dealing with Florida Medicaid Institutional Care Program (ICP) patients. This is because Florida has a large elderly population (65 years and older) which is projected to grow nearly to 26% of the state’s total population which is the highest among all states in the US.

The fact that these elderly patients are either disabled or are fighting chronic illnesses makes them frequent visitors to physicians’ offices and various hospitals. This fact coupled with the recent health care reform would ensure that health care providers would be required to ensure accuracy and compliance with legal guidelines in order to avoid a drop in revenue or negative legal repercussions. Our medical billing specialists ensure that problems such as inadequate reimbursement due to claim denial and other related factors do not take its toll on your practice.

Our medical billers and coders at medicalbillersandcoders.com can ensure an improvement in the efficiency of your practice by employing the best methods of optimally using your EMR, their exposure of various Practice Management Systems also provides greater collections for your practice.

And, even though pharmacy claims are distinct from hospital claims, they are still subject to the same HIPAA rules – which may be difficult to cope with during times of resubmission for being non-compliant with privacy or security norms.

These inherent challenges require a series of admin and data related activities, starting from verification, through claim preparation to submission, to be handled with accuracy.

Outsourcing Billing to MBC

MBC’s pharmacy medical billing and coding services would not just help you accurately discern which type of treatment comes under injectables or adjuvant therapies but also take care of the entire range of your admin activities from claim preparation thorough submission to post-submission follow-ups and audits in case of over payment by the insurer, improving your finances and leaving you with more time to spend on your core competency – pharmacy dispensing.

Our services cater to all kinds: clinical, home care, and radio pharmacy services.

  • Clinical – These services often come under bundled payment module, which may require handling paperwork of non-clinical nature. We take care of the entire paper trail that adds up to insurance claims in a methodical manner.
  • Home Care – Involved in preparation and delivery of injectables to home-bound patients, these services being covered by Medicare Prescription Drug Improvement and Modernization (MPDIM) require you to prepare and maintain details and do data handling that is not part of your core competency and interfere with their itinerant schedule which involves extensive travelling to patients’ homes. We have an extensive network spread across all states of the US and professionals who are experienced in handling billing activities related to home care services.
  • Managed Care – Similar to clinical services, these services are often operated from big hospitals and nursing homes that often realize their reimbursement through the bundled payment model. This requires maintaining non-clinical paperwork and producing reports, slicing away from the time you spend on patients and exposing them to data and procedural inaccuracies which often count against their performance as being part of these establishments. Our end-to-end billing and coding services spare you the headache of having to maintain your non-clinical paperwork letting you spend more time on drug dispensing.
  • Radio – Being among the most prominent adjuvant therapy services, these services come under the insurance coverage of the Medicare Prescription Drug Improvement and Modernization Act (MPDIM) and require billing and coding assistance. Our medical and billing and coding services have helped many Radio drug service providers improve their finances through efficient data handling, bill submission and follow-ups.

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