Pharmacy Billing In-house vs Outsource

A pharmacist is constantly striving to ascertain between different drugs and patients. They juggle between rules, regulations and learning in the modern health care industry.

The job just became more compounded with the pharmacy claim process.  Pharmacy billing has come to the forefront with increased regulations on the drugs prescribed and sold.

The rules and regulation have made it important for the pharmacist to maintain a medical ledger where all the medical bills and claims are registered in the proper format. This has made the process cumbersome for a pharmacist looking to serve people.  A pharmacy billing process requires a long documentation and constant monitoring with insurers to settle the claim. Now a pharmacist working on a medical solution will need an extra hand. Now you have two options,

Hire In-house team of coders and billers or outsource medical billing.

Here are some factors you should consider before making a decision:

  1. Admittance

The first step towards revenue generation involves capturing the medical history, previous prescription, previous doctors, insurance details, billing details etc. This will require many calls back and forth to different medical departments. If the process is outsourced to a team of experts who are tasked with every step this will make the admittance error free; with an in-house billers and coders the process will become complex with several patients visiting the pharmacy.

  1. Prior authorization

Prior authorization is one of the most important factor in the modern day healthcare system. When a patient is diagnosed with a disease which requires two different specialties to work together you will also need an approval from the insurer before providing the drug.  The drug can have certain side effects when combined with other drugs to prevent such risks we need a good prior authorization.  An outhouse team of experts will explicitly sort the drug issue.

  1. Refill management

Refill management is a golden step for a pharmacy for customer retention. Regular customers are impatient and look for other options if not satisfied with service of the current pharmacy. You need to have a proper refill management system to track the patients and provide them with a reminder when necessary. With outsource, you can task this to software which can track all the refills without any manual interference.

  1. Follow-up

Every service needs to get billed to generate revenue an outhouse team will accurately document and maintain records without you depending on the single person. The balance and billable need to be maintained properly to avoid goof-ups. An outsource team will follow-up with insurer or patients on regular basis with regards to payments and refill. With an in-house team, the detailing can become tedious with every new patient added.

At MBC we help pharmacist easily track their account receivables without any nuisance of calling the accounts department. The pharmacist will be billed according to the claims settled by the MBC, so no extra charge on hiring and software’s.

The important aspect looking at pharmacy billing is to have proper documentation with each and every step. At, we provide end to end pharmacy billing service. Reducing the data entry at different points and make a proper payment channel. We will ensure that you have a proper reimbursement at the properly accounted time. is one of the most trusted and reputed name in the medical billing industry. Deploying customized solution for pharmacy billing after understanding your needs.