Practice Management

5 Pharmacy Billing Mistakes Most Profitable Practices Avoid

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Acing pharmacy billing ensures efficiency of handling patients and adding revenue of the pharmacy. With the help of automated systems, pharmacy billing will be able to process claims faster, with more accuracy and should be streamlined. The practice of pharmacy billing today requires the suitable resources like operating and technological systems to enhance the productivity of the business. It has been observed that often the dearth of adequate human resource leads to time consuming pharmacy billing practices that make use of manual processing procedures. Staff employed has undefined roles and often lacks knowledge about various drugs and govt. Regulations of maximum dosage and allergy information. Additionally, decentralized sharing of the data and its processing requires tiresome duplication that increases turnaround time. Moreover, absence of information about pharmacy billing and insurance clauses result in major errors. Thus, we can conclude that pharmacy billing practices require high level of quality control when dealing with steep volumes and strict deadlines.

To reduce costs and improve the bottom line of business, here is a list of five pharmacy billing mistakes that most profitable practices avoid:

Mistake I: Having a Decentralized Billing System

The need for flawless automated systems which can help reduce TAT and allow better efficacies into the business is uncompromised. Profitable practices work with a central IT system to avoid record duplication and ensure a single point for all information. All the data and information about a patient’s treatment, medication, bills processing, insurance details, etc. needs to be accessible through a centralized system with real time updates. Not only does this minimize errors but also ensure better reimbursements.

Mistake II: Absence of Customized Processes

While a highly customized software or process may fall off limits for small individual pharmacies, developing or purchasing software that adapts best to the needs of your organization practices and IT infrastructure is recommended.

Mistake III: Lack of Common Vision

All profitable practices make sure that the roles and responsibilities of different employees in the pharmacy department are well defined. It is effective to communicate to each person the core purpose of the organization and then motivate them enough to work towards it.

Mistake IV: No Stringent Documentation

A concise success strategy of profitable practices is to create a detailed and comprehensive documentation of every patient that comes in. This sheet needs to be continuously updated and should be easily accessible. Clear and concise documentation filing assists in spelling the entire story of the patient clearly welcoming conducive action.

Mistake V:  Inadequate Staff Training and Information

To be best in class when it comes to pharmacy billing, it is important for its processes and people to remain ahead in comparison to their competitors in terms of task, crises management or any other situation. For a pharmacy to have a team that knows the business, it is important to provide cutting edge training resources and user friendly access to all medications and procedure information

that they require in order to provide more efficient services. Additional training may help in enhancing the productivity of employees and allows them to deliver quality services to patients. With the help of prompt updates, automatic refill alerts, early authorization processes, and real-time tracking can help the facility provide superior pharmacy billing services and lead the industry.

In today’s time, ever increasing complexity of healthcare industry that revolves around governmental regulations like additional codes and rules need to be followed with greater care now than ever. Conclusively, unique and valuable services like processing refills before time, working on inconsistencies of data, providing the right information and ensuring timely billing and claims can aid efficient pharmacy revenue cycle management.

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