Prescription drug spending is a billion dollar problem for the payer industry. While pharmacy benefit managers (PBMs) are often a positive way for payers to manage prescription drug benefits for their members, savings for payers can be limited because of complex or one-sided contracts that benefit PBMs more than their partners. The Pharmaceutical Care Management […]
The present day U.S. healthcare billing and coding process for patient care services is a multifaceted and difficult system for many to fully grasp. This especially vital for pharmacists who are relatively new to generating revenue for patient care services. Pharmacy billing is challenging for varied reasons, including multiple payers; distinctions of the locations where […]
The recent research reveals that about 85% of the hospitals in USA will witnessing a raise in their Medicare part B because of the recent changes in the Medicare outpatient payment charges hence; medical coding too get revised. The Medicare payment charges came into effect on January 1, 2018 which had revealed a major reimbursement […]
Pharma industry has been described as having a “roller coaster ride” in the year 2017 by The Pharmaceutical Journal. Inadvertently, one might assume that the industry is on the downswing but on the contrary it is on its ride up. Pharmacy billing is in big league in the pharmacy billing management as it is a […]
Have you ever stopped to think about how much your independent pharmacies are earning when it dispenses your medication? It turns out that pharmacies, particularly independent pharmacies, sometimes wind up losing money on those prescriptions. That’s largely due to the low insurance reimbursement rates middlemen, known as pharmacy benefit managers, or PBMs, pay pharmacies and […]
Artificial Intelligence (AI) is disrupting the information growth and how the information is processed and implemented? Though we perceive Artificial Intelligence (AI) as a machine replacement of human abilities AI does add more value to the already set process. Pharmacy billing which has seen a trifle of innovation will need effective technology to emerge as […]
Healthcare executives majorly depends on Pharmacy when it comes increasing their revenue. Without saying it goes hand in hand. Furthermore, CMS has reduced its Average Sales price margin from 6 % to 4 % for non-pass-through. This has affected pharmacy billing and reimbursement. However, there are certain other aspects of Pharmacy Billing that can affect […]
A recent survey forecasted that the pharmacy automation market will hit $8.8 billion in the year 2018. In the year of 2011, the pharmacy market was valued at $4.7 billion and nearly 60% of the generated revenue came from automated medication dispensing system. Pharmacists believed that this pharmacy segment is expected to see a compound […]
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 […]
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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