How Customized Pharmacy Billing Solutions Increase Client / Customer Satisfaction
With pharmacies, after accurate and timely medication delivery, the biggest worry on a facility’s mind is billing.
Medical billing is a hugely complicated process, and every facility has specific procedures. There is no one-size-fits-all solution to medical billing. Vendors must customize their billing process to match the needs of the facility.
At a minimum, there should be an itemized bill of which patients received which prescriptions, with subtotals for each one, and a final total at the bottom. There should also be a method to work with systems where a patient has a certain amount of money for medications each month. These are common in Long Term Care facilities and nursing homes, and are fairly straightforward. However,there are many medications that require special approvals, whether from insurance companies or from hospital staff, and that’s where complications come in.
Ideally, the pharmacy will have the information in their systems to immediately flag situations where an authorization is needed. The sooner they know whether a medication is covered and which authorizations are needed, the better. Obtaining authorizations to send out a medication is one of the biggest bottlenecks in the pharmacy process, especially for people who aren’t covered by medical insurance.
The preferred method can even change depending on the thresholds. One of the problems that can come in with a vendor transition is figuring out the vendor’s new billing and authorization systems. This can be quite challenging, but it doesn’t have to be.
It is not the pharmacy vendor’s place to offer their own authorization methods unless there is a clear need. Facilities have good reasons for why their systems are set up the way they are. Pharmacies must adapt, especially when a facility decided to transfer to another vendor. If you can show that they can keep their current billing system mostly intact, that’s a point in your favor.