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ELIGIBILITY AND BENEFITS VERIFICATION PROCESS
Author: Lavanya Duddu INTRODUCTION: Eligibility and benefits of verification process involve whether a patient’s eligible for certain term and condition and verifying the details of patients before patients visits. The patient data is entered and check verifying age limits and certain criteria Such as insurance name, phone number and claims address Name of insured as isn’t always the patient and effective date of policy and end date of policy If required team will initiate the prior notice and update

PRIMARY UNDERSTANDING OF MEDICAL BILLING AND PATIENT CARE SERVICES
Author: Korlapu Pallavi Introduction: To provide pharmacists a basic understanding of healthcare billing and current opportunities for generating revenue for their patient care services. BASIC KNOWLEDGE ON BILLING: The current U.S health care billing process for patient care services is a complex and difficult system for many to fully grasp, especially pharmacists who are relatively new to generating revenue for patient care services. Community pharmacists across the United States have had their scope of practice expanding for the delivery

Reasons Why Healthcare Outsourcing Should Be On Your Radar
Author: Nikhil Mane Introduction Outsourcing is the process of transferring responsibilities for a service or product to another party. Medical outsourcing is a subset of healthcare outsourcing where the responsibility for delivering medical care to patients is transferred to another party. Outsourced health care has been proven to save money and improve quality, which makes it an attractive option for hospitals and other care providers. Impact on the budget and the economy. Outsourcing medical care has been an attractive

Drug assistance programs and patient responsibilities on drugs
Author: K.Srivani, K. Sravani, K. Vaishnavi B. Pharmacy 2nd year, St. Paul’s College Of Pharmacy, Under the Guidance of Mrs. D.Shital, Dept. of Pharmaceutical Chemistry Lets together know about drug assistance programs and patient responsibilities on drugs Abstract The heading of the article is saying about two topics related to the drugs In this topic we have to discuss about drug assistance program which gives a piece of information about medications and affording medications with low cost and cost-sharing The

PRIOR AUTHORITAIZATION PROCESS, REQUIREMENTS, RULES, DIFFERENCE, SUMMARY
Author: Mythili Suresh PRIOR AUTHORIZATION PROCESS OBJECTIVE – In-some cases under the medical and prescription drug plans, some of the major treatments, procedure and medications may need approval from your health insurance carrier before you receive care from the provider of health insurer. INTRODUCTION – Prior authorization is usually claims to require if you need a complex treatment, mitigation, Prevention or prescription. Since the maximum Coverage will not happen without the prior authorization process. And hence that was the major

PHARMACY BILLING PROCESS
Author: Kasamma Definition: When a prescription is sent to the pharmacy bills the patient’s medicine insurance and dispenses the medication either directly to the patient or to the suppliers office. This process is known as pharmacy billing. Introduction: It entails documenting information about patient discharge, physician changes, etc. All of the information is crucial, especially if one of the clients wants to file a medical claim. Importance of billing step in pharmacy: The importance of pharmacy billing services in health

Standards of Healthcare Outsourcing Companies in India
Author: Nikhil Gupta Abstract: The idea of outsourcing denotes a connection focused on results with an outside service provider for tasks that are typically carried out within the company. Transformational outsourcing is focused on innovation and business advancements, as opposed to traditional outsourcing, which is based on business methods to lower costs and improve a firm’s efficiency and flexibility. The upshot of international economic and technological advancements is the offshore outsourcing of services. In India, this gained popularity after the

ROLE OF OUTSOURCING IN HEALTHCARE FIELD
Author: Chetana Menda ABSTRACT: Business Process Outsourcing (BPO) is the topmost business across the globe and is aligned to transform businesses with fully-managed expert solutions to provide the trusted independent resource. Health care service providers from all around the world are going to countries like India to outsource their non-core business procedures, making healthcare outsourcing the newest buzzword in the industry. The article’s goal is to briefly explain the function and significance of healthcare outsourcing. Keywords: Business Process Outsourcing, Global Healthcare,