Testing at Pharmacies Effective 15th January 2022, people with a health plan can go online, or to a pharmacy or store to purchase an at-home over-the-counter COVID-19 diagnostic test authorized by the U.S. Food and Drug Administration (FDA) at no cost, either through reimbursement or free of charge through their insurance. CMS is strongly incentivizing […]
Read More.. Testing at Pharmacies…Which Billing and Revenue Updates can Enhance Billing?Ensuring Successful Pharmacy Billing
Pharmacists play a major role in providing healthcare services to patients by physicians. And for all of us, these services are not a new thing. For years, pharmacists have been offering services over and above filling prescriptions from the origin of the profession. One of the developments in the pharmacy profession is, however, getting compensated […]
Read More.. Ensuring Successful Pharmacy BillingService expectations to have from Specialty Pharmacy
Specialty pharmacy refers to the channels of distribution designed to deal with specialty drugs. Medications used to treat rare or complex health conditions are provided by a specialist pharmacy. Many times, most people don’t use these drugs, so a local pharmacy wouldn’t hold them in stock. For patients in need of access to prescription drugs […]
Read More.. Service expectations to have from Specialty PharmacyMedicare Advantage and Part D Advance Notice for CY 2022
CMS released the Part I of the 2022 Medicare Advantage and Part D Advance Notice to provide plans with earlier notification of proposed payment changes. This announcement is made three months earlier than the usual to provide Medicare Advantage organizations and Part D sponsors more time to take this information into consideration as they prepare […]
Read More.. Medicare Advantage and Part D Advance Notice for CY 2022Avoid the Part D late enrollment penalty
Do you have creditable prescription drug coverage? It’s drug coverage that’s expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage. It could be drug coverage you get from a current or former employer or union, or from TRICARE, or the Department of Veterans Affairs. If you don’t have creditable coverage, you […]
Read More.. Avoid the Part D late enrollment penaltyPharmacy Billing and Reimbursement
Conventionally, pharmacist compensation has been majorly concentrated on collecting payment for the products’ provision, such as prescription medications. Nowadays, pharmacists possess an extended practice opportunity and the pharmacy profession has integrated different clinical avenues into regular patient care such as medication therapy management, chronic disease management, and care transitions interventions. A prescription has multiple stages […]
Read More.. Pharmacy Billing and ReimbursementTIPS FOR SUCCESSFUL PHARMACY BILLING IN 2020
Pharmacists perform a significant role in providing healthcare services to patients. And these services are not a new thing for all of us. Pharmacists have been offering services beyond prescriptions filling for decades from the origin of the profession. However, getting reimbursed for delivered services is one of the developments in the pharmacy profession. Moreover, […]
Read More.. TIPS FOR SUCCESSFUL PHARMACY BILLING IN 2020Key Points about Pharmacy Billing and Reimbursement
From the pharmacy to the side of the patients, the prescription has multiple phases of reimbursement for patients as well as pharmacies. Distributing medication from your own hospital could be one of the efficient as well as an effective way for revenue generation. The health care industry has transformed unconventionally over the past few years […]
Read More.. Key Points about Pharmacy Billing and ReimbursementUnderstanding Prescription Insurance Claim Process
After submitting a claim from the pharmacy, it will then hit a service that routes the claims to the proper insurance company or PBM based on the identifiers. These are known as ‘switches’; examples of companies that offer switching services include RelayHealth and Emdeon. Switches usually charge a fee for every transaction, although they might […]
Read More.. Understanding Prescription Insurance Claim ProcessPharmacy Claims and Commercial Payers
The most common categories of commercial payers to be aware of are employer-sponsored health plans and manufacturer vouchers. In the case of the patient with commercial coverage, by law, it is billed before Medicaid and Tricare and is almost always the primary payer. A common misunderstanding among patients with manufacturer vouchers (i.e. ‘co-pay cards’) is […]
Read More.. Pharmacy Claims and Commercial Payers