Accountable Care Organization (ACO’s) Needs Tech-intelligent Pharmacist

With an effort to access and improve the healthcare industry in USA; along with managing the costs which have been the primary issue since years; the introduction of ACO (Accountable Care Organization) whereby the providers have created a comprehensive network that works for the betterment of the patients, and it is appreciated as an achievement […]


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What Happens If Your Prior Authorization Doesn’t Match With Service Provided?

Prior Authorization for a drug is one of the foremost processes on which the financial health of a Pharmacy facility depends on. Today, with the advancement in the areas of EMR and EHR, Pharmacy billing personnel who work in-house or offshore have to guarantee in advance to their doctors about the patients insurance plan. While […]


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Should Community Pharmacy Transform For Revenue?

The U.S Healthcare industry at the moment is undergoing drastic changes, as the federal government gets ready with a new bill. Eying such a gloomy scenario is it the right time for community pharmacy billing to transform its business operating model for a higher revenue numbers? What impact will it have on the payer-provider front? […]


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New Technology to Improve Pharmaceutical Industry

Modernizing pharmacy is the new way to help industry to adopt scientifically sound novel technologies that helps manufacture quality medicines that are consistently effective and safe. Technology changes in pharmacy are not a new thing; but there was a hesitation of adopting the technology. Gradually the industry now embraces the information exchange via drug bar […]


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Five Innovative Approaches to Improve Your Pharmacy Billing

Today Pharmacists have transformed their practice from just being dispensers of medicines over the counter to providers of healthcare. They are increasingly providing direct patient care based on a scope that is directed in the states in which they practice in a variety of settings right from inpatient, outpatient, and community pharmacies. The most accessible are […]


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Importance of Accurate & Ethical Pharmacy Billing

Pharmacies practice their specialized clinical and advanced training that allows them to evaluate, monitor and adjust drug therapy while working in close collaborations with physicians and patients. Clinical services like medication monitoring, adjusting doses and regimens, and sometimes even changing prescriptions are some of the important functions that a pharmacist is trusted with on the […]


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Effective use of J-codes In Pharmacy Billing

Healthcare Common Procedure Coding System (HCPCS) is based on the Current Procedural Terminology (CPT) developed by the Center of Medicare and Medicaid (CMS). Till 1996, HCPCS was optional but after the passage of the Health Information Portability and Accountability Act (HIPAA), the government had made the use of HCPCS mandatory in certain cases. The HCPCS […]


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Strong Prior Authorization for Affordable Pharmacy Billing

Prior authorization (PA) requires a pharmacy to obtain approval from your health insurer to dispense a specific medication prescribed by the doctor to you. The PA clause is usually put to use in case for very expensive medication. The adoption of PA technique is known to minimize health care costs, as the benefits are only […]


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Common Pharmacy Reimbursement Strategies to Calculate Insurance Payments

The current fee-for-service reimbursement model places the incentives on volume over value, lacking any scope for preventive care and care coordination among providers. In order to lower down the cost and improve medical outcome the payment structures need to be redesigned to focus incentives on results and overall value of healthcare. Here are some research […]


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Save 9% On Medicare Payments By Reporting PQRS

Quality measurements and quality data reporting are an integral part of Medicare programs. PQRS (Physician Quality Reporting System) is one such reporting that is to be demonstrated to meet the quality performance standards. PQRS is a quality reporting program that boosts group practices and individual EPs (eligible professionals) to report about quality care to Medicare. […]


Read More.. Save 9% On Medicare Payments By Reporting PQRS