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Pharmacy Billing Services Texas, TX

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.

Maximizing your office’s efficiency and cutting your costs are some of the priorities of our medical billing and coding specialists located in Texas. Like everything in Texas our database of Medical Billers and Coders is huge in texas, these billers cater to various specialties and software exposure.

With extensive medical billing knowledge coupled with their years of experience, they help providers and practices in and around the state to maximize their reimbursements and minimize their costs.

Our billing professionals are present in major cities in Texas such as Houston, San Antonio, Dallas, Austin and Fort Worth. Some of the services they provided are:

  • Data entry of all charges
  • Submission of electronic as well as paper claims to both primary and secondary insurers
  • Accurate ICD-10 and CPT code audits
  • Payment postings after receiving from insurance companies as well as patients
  • Excessively customized Monthly financial reports
  • Comparing payer fee schedules and updating your practice about it

The state of Texas is known for its clean claim law which is considered to be one of the most helpful and powerful in terms of clean claim violation and can make the payer to pay billed charges. The law states that the payer has to pay a clean claim within 30 days, with the option of 45 days if the claim is not submitted electronically, thus our Texas billers will be able to reduce your AR days noticeably.

Our professional billers in Texas are trained to handle all aspects of Revenue Cycle Management which specially includes denial Management and helps you recover rejected claims by appeals and resubmission of claims.

Our Billers in the state of Texas are specialized to service medical practices as per the regulations of the state government. Their knowledge and experience has been acquired by years of efforts in perfecting medical billing procedures which they now leverage to help your practice collect more revenue.

The federal government’s effort to reduce healthcare cost can only be supported by physicians in the state of Texas by optimizing costs and enhancing revenue. Letting a specialist handle your medical billing can help you improve collections by 20%.

Accurate Coding and code audit along with timely insurance follow up and account receivables are the basis on which thesebillers in Texas guarantee higher profitability for your clinic. Their experience in various software and certification in the medical billing processes will support your practice to grow steadily.

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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