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Pharmacy Billing Process

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Author: Sristy Kumari

 

In today’s growing society and era of healthcare industry and other healthcare departments presenting new,vast and complex challenges for our pharmacy business. We are struggling and face problems such as underqualified staff, wrong drugs records, and legacy billing systems. For resolving such problems we optimise our processes for correct invoice generation and timely dispatch with our pharmacy billing services. The pharmacy billing service is very helpful in adds agility and precision to our billing functions,it help automate the process of generating invoices and sending out reminders for our delivery. This process indicates that our care toward our customers resulting to increased loyalty and increased confidence in our pharmacy. It helps also to increase sales . Pharmacy billing is process by which the b⁸illing occurs when a prescription is sent by doctor to pharmacist to give given medication and lastly bill to a patient ‘s drug insurance. It involves all patient records like discharges, changes of physicians etc. All of this is important mainly for customers if he plan to make a medical claim.The main reason for increasing pharmacy billing software is its ability to better manage patients accounting information and clinical patients. It also help in the processing of insurance claims for a fast reimbursement and properly functioning of a pharmacy and requires precision and integrity it also accelerate our billing procedure by automatically calculating discounts,taxes,posting, reimbursement etc and it can also help us to strengthen our billing systems and insert the rights codes gor accurate billing. It is very important process to build up believed toward our client. In pharmacy billing process we provide our customer first class service with effective cost and best in class services. This is possible by use of systematic process. Technician also in charge of billing process. Each and every pharmacy accept different insurance claim. Technician acquainted with normal billing procedure. Formulary firm knowledge is necessary in pharmacy billing process.

  • In billing services to us , we follow a structured billing workflow, which involves:-
  • Documentation-Our medical staff and experts will work together to complete the documentation of medicine ahead of pre-authorization.
  • Eligibility verification and billing – We check the eligibility of our customers by verifying their healthcare and payment records before billing Medicare, Medicaid or other commercial insurance of our customer client.
  • Plan review and authentication- After billing, we clarify that the Medicare Part D to ensure the patient is cover under the right plan and communicate to other patient eligibility requirements and corrections is required if necessary.
  • Billing statement- It this step we provide a statement regarding comprehensive electronic billing on pharma services available by the patient and on billing services it must require to update records.
  • Refill management- During this stage, we provide the service to the refill needs of the patients and also dispatch timely reminders to them on refill.
  • Payment capture and posting-The payment is released by insurers is posted to the customer’s account on a day-to-day basis so that all the payments process stands captured correctly at the end of the day .

There are also pharmacy billing software are evolved-

There are several automatic billing software are upgrade to perform smoothly lies critical and repetitive tasks like date capture. The software we use for billing management includes- NEXTGEN, KEREO, MEDISOFT, ATHENA, BRIGHTREE, EPIC, ADVANTX

We need to prefer pharmacy billing services company some of main benefits of partnering with is include –

  • Certification- They are RBMA corporate partners and ISO certified. All their processes are HIPAA, ICD -11 and DSM-5 compliant . Their pharmacy executives are experts and well-trained and follow recommended billing procedures to ensure data confidentiality.
  • Data security- It is very necessary to secure all the data regarding patient data when it comes to pharmacy billing. Apart from singing confidentiality agreements and also conduct regular audits to ensure that all client data is 100%secure with us, and not to be compromised at any cost.
  • High accuracy and quality service-At a generic drug or branded/unbranded drugs , we have professionals who has to understand the nuance of pharmaceutical drug categories. The broad knowledge of handle a variety of documentation with unmatch quality and
  • Short turnaround- We also provide sufficient pharmacy billing services and reports within a quick TAT . We can be save 35% of the time on our activity while we handle pharmacy billing service.
  • Scalability- We solve the custom billing solution with an requirements or needs in future as our business evolves, we may face higher billing volume and complex regulatory compliance. This will be need to take care because our billing solution are designed to handle scaling demand.
  • Single – point- contact – If we wish to contact and consult with one dedicated handler rather than many,we have heard your concerns , since the person appointed to interact with you is well advised about the project,this can be updates our need it can be available on

We need to preferred pharmacy billing services company some of main benefits of partnering with us include–

  1. Certification-They are RBMA corporate partner and ISO certified. All there processes are HIPAA, ICD-11 and DSM 5 compliant their pharmacy executives are experts and well trained and follow recommended billing procedures to ensure data confidentiality agreements and also conduct regular audits to ensure that all client data is very helpful in adds agility and precision to our billing functions and the quality of the day is not to be compromised at any
  2. Admission- Admission is the step in pharmacy billing process and it involves recording the details of the patients like their name age,blood group,medical history,diagnostic reports,previous prescription,known any allergies etc .
  3. Prior authorization document management-The billing systems we develop to ensure that a complete authorization are taken before the processing This management ensures that patients are always covered by a health plan and there are minimal claims. Our authorization systems are set to handle every Adrug category and emergency levels.
  4. Refills management is area that requires very much attention and faster actions,as our customers are not going to very patient with you the second time the come around. As a top pharmacy billing process company we help set up all necessary approval and reminders so that when a customer comes in for a refill,we can process it right away without any delay
  5. AR follow up – Every small services that not get billed impacts our bottom line directly, so we take care and handle it with a lot of This is ensure that only services performed are captured and billed at the right time.
  6. Payment posting- This is most labour-intensive activity in pharmacy billing,but the good news is we can automatically post the insurance payment,and reduce the data entry time .

The advantages of pharmacy billing process is –

  1. It reduce the error in medication
  2. Time interval is reduce
  3. Decrease in total cost of medication related activities
  4. Improved drug control and drug use monitoring
  5. More accurate patient billing for medications
  6. Minimization of credit of drugs
  7. Greater control by pharmacist over work patterns and scheduling
  8. Reduction of inventories maintained on nursing units
  9. Ready availability of the drug required
  10. Elimination of drug return
  11. Reduction in number of drug order transcription for

The disadvantages of pharmacy billing process is :-

  1. It may be medication error increases because the review of medication orders is eliminated
  2. Increased drug inventory on the pavilions
  3. Greater opportunity for pilferage
  4. Increased hazard associated with drug deterioration
  5. Lack of proper storage facilities onward may require capital layout to provide them and their is difficult to correct the bill after complete the billing process .

And lastly , the pharmacy billing process is very helpful to pharmacists who related with wholesale and retail sale .It provides accurate , effective and within minutes gave accurate result . Digitally calculating bill is comes to reduce further problems related to incorrection in bill. There are software is also came to ease our problems to calculate easily all the bills accurately and effectively. We understand there is no one like faulty lethargic pharmacy billing solution that takes more time than the medical procedure itself. We need a system that automatically calculates and iterate the taxes, discounts, reimbursement and postings, and we are here to help our customize one .We have always developed systems that have exceeded industry benchmarks with this service we can also streamline our billing functions,reduce the billing turnaround time and significantly cut operational cost . The pharmacy billing process is now modified by many more softwares their services providers are updated her software very latest version through this the billing process is now easier. The billing software are accepted in all over the india because the wants to solve their problems related to billing . The bills is also very useful to clients in sense of maybe in future he wants to claim in medication through this bill and further pharmacist can take action through this bills . That’s all the billing process is very necessary to all pharmaceutical industries, pharmacies, hospitals and many more places.

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