Offering patient care services is an incredible opportunity to grow your business, increase your profits, and become a community caregiver, all at the same time.
Although clinical care in pharmacies is nothing new, pharmacists being compensated for those services is a more recent development. According to a recent survey on the top challenges independent pharmacies are facing in 2020, many feel getting paid is becoming more challenging, with 62 percent seeing declining reimbursements from third-party payers. Additionally, more than 80 percent of independent pharmacies either currently use, or plan to soon implement, some form of a billing solution.
While expanding your clinical services is a great opportunity to offer quality patient care and increase your pharmacy’s revenue, you need to know how to bill and get paid for the services you provide—not to mention how to make sure it happens accurately and efficiently. With the right medical billing software, you can optimize your reimbursements for any clinical services you offer, and in turn, improve how you care for your patients.
Improving Patient Care with Medical Billing Software
To provide greater value to your patients and the communities you serve, you need to go beyond just filling and billing by enhancing your clinical care services. Given the choice, most people would prefer to see a pharmacist for a flu shot or a diagnostic test, as opposed to their primary care physician.
Coupled with the fact that most people are statistically closer to pharmacies than their doctor’s office—especially in rural communities where care access is even more limited—these services are incredibly convenient for your patients. Here’s how Nancy Lyons, Chief Pharmacist at Health Mart, explained the evolving role of pharmacists in clinical care:
“As we move into the new decade, the role of the pharmacist will continue to broaden the reach of patient care to fill in gaps and provide even more value to a healthcare consumer who will demand quality, convenience, and control of the health and wellness journey. The impact that pharmacists will make will start with the patients and caregivers within their practices and expand to opportunities to impact public health. This is especially true for independent community pharmacists, who provide a growing set of valuable services while directly investing in the local communities where their own families live.”
Gaining the ability to bill for any medical services, equipment, or supplies will help you increase your pharmacy’s cash flow, enabling you to expand and enhance your patient care services, minus the administrative burden and learning curve that comes with navigating medical billing intricacies. With advanced pharmacy technology available to guide the billing process and help streamline reimbursement, you can offer a myriad of patient care services, such as:
- Flu shots and other immunizations
- Durable medical equipment and supplies
- Diabetes prevention and management programs
- Medication therapy management
- Point-of-care testing (including for COVID-19)
- Smoking cessation counseling
- Biometric screenings
- Medical nutrition therapy
Offering these types of patient services will not only help you deliver better care, but also give you a competitive edge that helps set you apart. While many of the big box retail pharmacies like CVS, Rite Aid, and Walgreen’s now offer clinical care services, they’re not equipped to deliver the same patient-centered care as community pharmacists. You can provide the same convenient services, all with a personal touch they’ll only receive at a small independent pharmacy.
Increasing Your Pharmacy’s Cash Flow with Technology
A medical billing solution with the right features will help you optimize your reimbursements and increase your pharmacy’s cash flow. Medical billing software for pharmacies offers several benefits, including:
- Get electronic eligibility verification to simplify workflows
- See claims status and management through queues
- Gain the ability to track refills, secondary, and held claims
- End error-prone, time-consuming manual processes
- Ensure claim accuracy with medical billing codes
- Review explanation of benefits tracking/repository
- Reduce denials with claims reconciliation
Medical billing software also enables independent pharmacists to work more efficiently, freeing up more time to spend helping patients. Of course, your vendor choice matters when choosing a medical billing solution—especially amid the COVID-19 pandemic, which has introduced several changes from new medical billing codes to point-of-care testing opportunities for pharmacists.
What to Look for in Pharmacy Medical Billing Software
So, what type of medical billing software makes sense for your pharmacy? Which features are must-haves, and which are just nice to have? And, how can you differentiate the so-so solutions from the best?
To help you weigh your options and make an informed decision on the right medical billing software for your pharmacy, here’s a list of the must-have features to look for:
- Integration with your existing pharmacy management system (PMS)
- Optimization for patient care services, like flu shots and diagnostic testing
- Ability to optimize reimbursements for medical services and supplies
- Electronic insurance eligibility verification to avoid treatment delays
- Access to claims status, responses, and management queues
- Ability to track refills, rentals, secondary claims, and held claims
- Education and training programs on point-of-care testing
- Alerts on the latest medical billing and coding regulations
- Comprehensive data and analytics to generate reports and track claims
- Access to customer support should you run into technical issues or errors
Investing in medical billing can be a true game-changer when it comes to increasing cash flow and empowering pharmacists to expand their clinical services to improve patient care, while also providing community empowerment. Using medical billing software with the features outlined above will allow you to focus on what you do best—helping and caring for patients—rather than constantly crunching numbers like an accountant.
Looking for a way to make expanding your clinical services to improve patient care as feasible as possible? Schedule a demo of FDS MEDBILL for a firsthand look at how you can grow and transform your independent pharmacy business with a comprehensive medical billing solution.
