insurance verification for pharmacy practitioners Archives

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

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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 […]

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 […]

Insurance vs. Out-of-pocket Payment: Which Option is better for Pharmacist?

Having a pharmacy business is no easy task considering the nature of Insurance versus out-of-pocket expense that both the patient and the pharmacist have to abide by. The pharmacy benefit manager (PBM), most of the time charges their customers more than the medicine costs and pockets the leftover difference. This is where an efficient, relevant […]

Pharmacy Billing: Channelize Your Reimbursement Without Affecting Your Facility

The quantity of administrations provided by doctors, clinics, and nursing homes to their patients is consistently expanding. Each time patients are given treatment and care, they owe a specific amount to the healthcare service provider in the form of reimbursement. Same is the process with Pharmacy facilities, as channelizing repayments without affecting their facility is […]

Pharmacist Reimbursement: Tips to Improve from the Leaders

Pharmacies today are home to various financial challenges that result from their limited role, rising medication cost, complex contracts with insurance providers and ever-evolving regulatory policies that tend to work in favor of the patients. They often face cost pressures that impact their revenue cycle management. While focusing on various aspects of running a pharmacy […]

Pharmacy Benefit Manager: Performance Benefit and Ineffective Management

Drug therapy, compared to hospital treatment and the surgical procedure is more coherent of medical treatment. According to the recent analysis of Kaiser Family Foundation, the per capita expenditure on healthcare is expected to rise from $9,695 in 2014 to $15, 618 in 2024 with an annual average growth of 5%. When the U.S. policy […]

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 […]

MBC Launches Customized Insurance Verification Services for Pharmacy Practitioners

Insurance verification is a critical component in any pharmacy revenue cycle management. As per industry data, more than 70% of all billing claim denials occur due to incorrect billing by the pharmacy practitioners to the insurer. There are occasions when policies are modified, employees switch plans for better benefits, policy gets terminated or expired etc. […]

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