Pharmacy Billing Services

How does a RCM Pharmacy manager can benefit and impact the ecosystem?

Drug therapy, compared to hospital treatment and the surgical procedure is more coherent of medical treatments. Who’s in charge of prescription benefits? Many people think that prescription drug aids come straight from a health insurance provider, when in fact, there’s a very important intermediary doing the bulk of the work for over 80% of employers in the U.S.A.

National Community Pharmacists Association identifies 3 major regulatory concerns:

  • The absence of precision and transparency in the revenue streams.
  • There’s always struggle between retail pharmacy and specialty pharmacies.
  • Unclear generic drug pricing and maximum allowable cost payment calculation.

Who Are RCM Pharmacy Managers & What Are Their Responsibilities?

RCM Pharmacy Manager has 2 primary responsibilities: lessen the pharmacy drug spending within prescription benefits plan and to help patients to achieve better health results through getting them better access to prescribed medications and treatments.

Hence; to carry these responsibilities the RCM pharmacy managers are required working with wholesale pharmacies, drug manufacturers, plan sponsors and retail pharmacies as well to facilitate the best possible health outcomes at the best possible costs.

How RCM Pharmacy Manager Can Benefits And Regulate the Ecosystem

  • Using RCM pharmacy manager staff service, such as MBC, means you don’t have to worry about workman’s compensation costs, health benefits, etc. as these are covered by the staffing service.
  • You will be saving significantly on payroll taxes since the per diem workers aren’t your employees; they’re employed by the staffing firm.
  • You’ve no need to screen or interview short-term pharmacy professionals (unless you want to); the staffing firm recruits workers, reviews resumes, interviews potential workers, and checks backgrounds, licenses and references.
  • It helps strengthens existing MAC Law Enacted In 2013 furthermore; attempting to create accountability in the prescription drug pricing.
  • It regulates how drugs can be put on the MAC lists and further how these lists are made available to the pharmacies.
  • It requires updating the act every 7 days hence; it is imperative to see the process of the pharmacies disputes and the price billing with PBMs.
  • It requires RCM Pharmacy Manager to itemize the individual claim the amount which is actually paid to the pharmacist or pharmacy as well as the identified pharmacist services.

MBC brings transparency to the complex prescription drug ecosystem. MBC help companies manage their relationships with their RCM pharmacy managers furthermore; helping feel certain that you are maintaining affordable, high-quality coverage for your employees.

Send us an email to learn how we can help facilitate your relationship with your current RCM PBM, or help you find a RCM PBM that’s right for you.

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