How to claim a faster reimbursement rate in pharmacy billing?

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• How to claim a faster reimbursement rate in
  pharmacy billing?

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How to claim a faster reimbursement rate in
pharmacy billing?

• Among the many processes to claim a faster
  reimbursement rate in pharmacy billing that could
  be streamlined through technology, pricing
  verification, reimbursement accuracy, prescriber
  and patient dispensing verification along with
  prior authorization. This not only aides in
  improving pharmacy claims reimbursement, but your
  facility will also reap operational benefits.
• Major factors driving complexity in the pharmacy
  claims process
• There are three reasons why community pharmacies
  need to improve pharmacy claims management
• Regulatory compliance
• The state and federal guidelines governing who
  can prescribe medicines, and who can dispense
  them grow more complex each year. Along with that
  regulatory oversight of drug manufacturers and
  distributors, and the pharmacies face a rising
  compliance challenge.
• Medication benefits
• The prescription drug benefits that healthcare
  plans provide are increasing in complexity.
  Pharmacy owners have to navigate benefit tiers,
  various co-payment and co-insurance levels,
  direct and indirect remuneration (DIR) fees,
  prior authorization requirements, and more.

Medical Billing Services in Oregon
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How to claim a faster reimbursement rate in
pharmacy billing?

• Reimbursement Rates
• Health plans continue to lower the reimbursement
  rates for prescription drugs. This downward
  pressure intimidates pharmacy reimbursement
  rates. One way pharmacists can ensure a higher
  reimbursement rates is via a thorough pharmacy
  medical billing and coding professionals.
• Pharmacy claims management and reimbursement
  functions that should be automated
• Dispensing Coding
• The dispense-as-written (DAW) codes tell clearly
  about the healthcare plan of the patient or a
  specific brand-name drug requested by them. If
  the DAW code is entered as a default code, the
  pharmacy may get a lower reimbursement for the
  actual brand-name drug it dispensed.
• Inventory Management
• Validate the national drug code (NDC) assigned to
  medicines for which claims were submitted. Most
  often or not, drug manufacturers recycle NDCs,
  which means a code could become obsolete for a
  discontinued drug. The code edit notifies
  pharmacies and the patient of an obsolete NDC,
  and potentially increase reimbursement.

Medical Billing Services in Oregon
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How to claim a faster reimbursement rate in
pharmacy billing?
Dosage and packaging Always check the pharmacy
claim for a specific medication, its dosage and
the drugs unit-packaging for the drug and its
recommended unit-packaging. Reimbursements for
drugs dispensed with the right dosage and
packaging codes will help your facility to get
reimbursed appropriately. Prior authorization
services Automating this work undertaking or
letting the experts in pharmacy medical billing
and coding streamlines key portions of your claim
reimbursement. Remember that the prescriber and
need prior approval from a health plan to give a
specific medication to a patient. This helps them
to avoid treatment delays and increase customer
satisfaction. By automating the pharmacy
reimbursement claims through technology, and
partnering medical billing and coding
organization pharmacies can put themselves in a
much stronger position to address the main
factors of their business, which is making
pharmacy claims reimbursement a streamlined
process. All in all this combination helps
maximize revenue, expand cash flow and generate
operating efficiencies by reducing billing and
coding errors that derail your income cycle.
Medical Billing Services in Oregon