Outsource Pharmacy Billing Services

We Strive to Improve Bottom-line with Improved Billing

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Physician billing

Some of the issues faced by the pharmacy services billing are the consistently changing administrative structure, presence of different payers, various areas of drug stores, among others like a portion of the basic factors. This is adverse for businesses who look to improve their client relations and enhance their income. The absence of the assets with the essential ability, satisfactory innovation selection, and appropriate operational framework can crash the overall measure. The market is sensitive and witnessing major competition which is giving rise to unique challenges for the service players.

 Hence, DigiMedix professionals are equipped to give far-reaching and reliable services. Utilizing the deep understanding and analysis of the business cycle, we have had the option to make use of various levels of customization and hence, keep the framework functioning in real-time. This has assisted and helped us come a long way in providing the customers just what is needed by them. Another vital notable component of DigiMedix’s physician billing services is that they play a major role in reducing operational costs and working expenses. Moreover, our billers are trained to function by keeping the coding rules and HIPAA rules in mind. We record drug classification surveys and complete consistent reviews to reduce the chances of committing coding mistakes.

How is
effectiveness
ensured?

We adopt the care billing codes that help us in covering patient bills who have been discharged

Our team is trained to comply with the CPT codes and guidelines to ensure error-free billing

We make sure that the drugs purchased have the HCPS coding

Different processes for generic and non-preferred drugs for minimizing rejections

Maintenance of a pharmacy charge description master to enlist all the billable items

 

Our end-to-end Pharmacy Services Billing Process

Details Receipt

We receive and access details from the Pharmacy Benefit Management (PBM) team through secured FTP tools. It is followed with negotiation with manufacturers for better discounts.

Verification of details

The negotiation is followed by a thorough verification of patient details including name, SSN number, address, physician details, among others.

Document Verification

Each document a thorough scrutiny and is then shifted to a data format that can be read by a system.

Check for Drug Refill

The data is then processed for medication refill check to understand the quantity of drugs in view of the prescription duration.

Identifying Prescribed Drugs

It involves the identification of the brand term of the prescribed drugsand suggestion of generic terms for molecules.

Placing the Order

We place the order in our client’s software, copies of which are sent to the patient and the insurance provider.

Tracking the Order

We ensure a prompt delivery of the consignment to the patient; any issues are quickly escalated to the logistics team.

Billing Management

Post receiving payment checks, we update the billing software and trigger reminders for payment due dates.

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