Is your biller doing the right data handling and follow up in pharmacy billing management?

In the healthcare industry Pharmacy is an integral part just like other disciplines in this field. However, it also poses certain billing and coding challenges that may often be difficult to manage internally. Also, because certain drugs are excluded from the insurance provider’s coverage where only a few injections and adjuvant therapies allowed, it may […]

Pharmacy medical billing: Lower Drug Prices in Medicare Advantage and Part D

CMS is allowing Medicare Advantage plans to cross negotiate Part D drug prices Starting in 2019, insurers may use step therapy to choose the least expensive drug first before moving on to another prescription. For the first time in the history of healthcare US, Medicare Advantage plans that also offer a Part D benefit have […]

What every pharmacist should know about in Pharmacy billing?

As a Pharmacy specialist, you may believe that your most troublesome errands will incorporate helping patients and monitoring conceivable contraindications between prescriptions. In any case, numerous drug specialists state those errands are simple and contrasted with the one-of-a-kind bookkeeping and accounting required in a drug store. Pharmacy billing is no basic issue, in spite of […]

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 […]

Understanding The Nuances Of Pharmacy Billing

The present day U.S. healthcare billing and coding process for patient care services is a multifaceted and difficult system for many to fully grasp. This especially vital for pharmacists who are relatively new to generating revenue for patient care services. Pharmacy billing is challenging for varied reasons, including multiple payers; distinctions of the locations where […]

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

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 […]

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? […]

How to Make Your Pharmacy a Wellness Clinic?

Altercations in the role of a pharmacist’s in the community pharmacy are impacting the highly evolving healthcare ecosystem and the trends will continue to grow in this rapidly transitioning system. The present-day pharmacies are not just your traditional drug stores, which offer you the prescribed medicines and jot it down in the medical billing, but […]

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