Are you struggling to survive in an economy where margins keep reducing and the competition keeps increasing? Are you looking for a system which can automate your billing management systems? Then, pharmacy billing is what you need! Irrespective of the sector and the vertical, companies are relying on automating their management systems. One of the most important systems that have caught the attention of pharmacists all over is the pharmacy billing management system, which is a part of the everyday functioning of a pharmacy and requires precision and integrity.
Flatworld Solutions can provide you with the required pharmacy billing system which will accelerate your billing procedures by automatically calculating the discounts, taxes, postings, reimbursements, etc.
Pharmacy Billing Services Offered by Flatworld Solutions
Daily Census Updates
Census maintenance is a very important function from a medical billing point of view, as it involves creating proper records of the patient and the payee. It involves recording information of patient discharges, change of physicians, etc. All this is essential especially if your customers plan to make a medical claim.
Admission is the first step in the medical billing process and involves recording the details of the patients like their name, age, blood group, medical history, diagnostic reports, previous prescriptions, known allergies, etc.
Prior Authorization Document Management
The billing management systems we develop ensure that complete authorizations are taken before the processing begins. This ensures that the patients are always covered via a health plan and there are minimal claim denials. Our authorization systems are set to handle every drug category and emergency levels.
Refill management is another area that requires great attention and quicker actions, as your customers are not going to be very patient with you the second time they come around. We will help you set up all the necessary approvals and reminders so that when a customer comes in for a refill, you can process it right away without any delay.
We know that every small service that doesn't get billed impacts your bottom line directly, so we take care and handle it with a lot of attention. The most important aspect of this service is to ensure that only the services performed are captured and billed at the right time.
This is probably the most labor-intensive activity in pharmacy billing, but the good news is that we can automate it. We will help you streamline the manual payment postings, automatically post the insurance payments, and also reduce the data entry time.
Why Outsource Pharmacy Billing Support?
Implementation of a business processing system is an expensive deal. There is a huge amount of investment in terms of both time and money. The understanding of this very fact has helped us come a long way with our customers. We have been able to provide high levels of customization so as to keep the system as close to reality as possible. This has helped our clients feel accustomed to the system, as has been possible because of our in-depth understanding of the business processes. With our experience, we have drastically reduced the operational costs for many of our pharmacy clients.
Our Team of Pharmacy Billing Experts
Our team of experts comprises of well-qualified and experienced accounts and finance personnel, and clinical experts who have complete working knowledge of -
CPT codes and coding guidelines
Documentation for drug category review
Different processes for A-rated Generic Drug, Brand Name Drug, and Non-Preferred Drug, which helps us minimize rejections
Awareness of all compliance audits, thereby reducing the drug coding errors
Creation of tailor-made statistical and analytical reports for the clients
Each member of the team is highly motivated and aims at delivering results in the shortest span of time with maximum efficiency. They ensure a constant increase in cash flow and consistent reduction in costs.
Our Pharmacy Billing Process
We believe in providing our clients with cost-effective and the best-in-class services. This is possible by making use of streamlined and systematic processes. Some of the key steps involved in our pharmacy billing process include -
Receive Mail Order
In the first step, we receive the mail order from the Pharmacy Benefit Management (PBM) team via Opex or any other FTP/scanning tools. The team would negotiate the costs with the manufacturer for better discounts
Once the negotiations are done, our team of pharmacy billing experts will verify all the patient details such as name, address, SSN number, dependent information, etc. and the physician details such as name, NTI number, etc.
Data Conversion Entry
Each document is scanned, classified, and converted to a system-readable format from the original scanned format
Medication Refill Check
Once the data is converted, the medication refill status is checked which will help in understanding the required quantity of medication considering the duration of the prescription
Organizing Prescribed Medicines
In this step, we find the exact brand name of the prescribed medicines and suggest the generic names of the molecule, cutting down the costs even further
If the medicine prescribed is generic, then we go ahead and place the order in the client's software. A copy of the order will be sent to the insurance company and one to the patient. For emergency kits, the order is usually placed within 30 minutes of receipt
We have a dedicated team to keep a track of the consignment till it is delivered to the patient. The escalations are followed in cases where the delivery is delayed at the logistics end
Once we receive the check for payments, we update it into the billing management system and send our reminders for due dates of the payment. Apart from this we also provide AR follow-up and payment posting services if required
Client Success Stories
Case Study on Full Service Billing by Using Medisoft
Find out how our team at Flatworld Solutions managed Full Service Billing for a Florida-based customer and brought down their average AR days from 141 to less than 40 days.
Having been in the healthcare services domain for over 12 years now, we have gained enough experience of working with clients from different parts of the world. Some of the reasons for you to choose us include -
We understand the importance of safeguarding patient data when it comes to pharmacy billing. Apart from signing confidentiality agreements, we also conduct regular audits to ensure that all client data is 100% secure with us, and not compromised at any cost.
Flexible Pricing Options
Pharmacy billing requirements vary from customer to customer hence we provide each client with customized pricing models which will exactly suit their requirements.
All our processes are HIPAA, ICD-11, DSM 5, and RBMA compliant, and our healthcare support executives are well-trained and follow recommended billing procedures to ensure data confidentiality.
Our team of pharmacy billing experts has access to the best infrastructure in terms of world-class office spaces, uninterrupted network facilities, and state-of-the-art billing tools and technologies. This helps us offer best services to our clients in faster turnaround and most affordable rates.
Flatworld has been providing various healthcare support services to global clientele for over 12 years and has over 100 years of combined management experience. We have a trained, skilled, and experienced team of pharmacy billing experts capable of handling any of the billing management requirements within a quick turnaround time.
We assign a dedicated project manager to every client who will keep them updated with the project status regularly. Additionally, they will be available via email, chat, or phone to solve any client queries during your work hours no matter what part of the globe you are in
Secure File Transfer
We use some of the most secure methods such as FTP to transfer files. Our team can also remotely log into your system and work on the files if you prefer not sending over the files and want the work done on your own machines
Outsource Pharmacy Billing to Flatworld Solutions
Flatworld Solutions provides a reliable and efficient medical billing service. They have helped improve collections and lower receivables for my clients.
At Flatworld solutions, we understand that no one likes a faulty, lethargic billing system that takes more time than the medical procedure itself. You need a system that automatically calculates and iterates the taxes, discounts, reimbursements, and postings, and we are here to help you customize one. We have always developed systems that have exceeded industry benchmarks.
Right from medical coding to billing, there is nothing that we can't handle. With a creative mix of advanced technology and billing professionals, we develop solutions that help you get all the billings posted automatically and at a reduced turnaround time. Contact us to know more our pharmacy billing services, our executives will be glad to assist you.