pharmacy billing reimbursement Archives - Read our latest Pharmacy billing and coding blogs

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 […]

Pharmacy Billing Coding Updates You Can’t Afford to Miss in 2018

The pharmacy practice is evolving along with changes in the healthcare industry. With this transformation, the supply and demand factors related to pharmacy services are also transforming. In the coming days, patient demands on the healthcare procedures are expected to increase ominously and outpace the current provider supply nexus. Team-based approaches have been regarded as […]

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?

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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 […]

How You Can Evolve Your Pharmacy Practice In 2018?

As we gear to welcome another year, altercation in the field healthcare especially Pharmacy practice and management of medical billing and coding for the prescriptions is going to be a daunting task. Evolvement in terms of monetary gains, structured revenue cycle and speed of reimbursement shall be dealt with precision and by the hands of […]

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? […]

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 […]

Why are Pharmacy Billing Specialist Important for Maximizing Revenue?

Amidst cut-throat competition widespread in the medical industry and margins that have maintained a constant downward run, only a well-managed Pharmacy can maintain a sustainable existence. Pharmacy Billing Specialists with the help of automated management systems, mind-full billing techniques and procedures pursue every feasible measure to turn the business into a profiteering one. Anyone who […]

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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