Optimized Pharmacy Billing: Expert Management for Maximum Returns
What Philadelphia Medical Billing Services Can Do for Your?
At Philadelphia Medical Billing Services, we go beyond basic billing solutions. We offer a comprehensive range of pharmacy billing services designed to address every aspect of your billing process, ensuring accuracy, compliance, and efficiency at every step.
Medication Claim Processing
We offer full-spectrum medication claims management services that involve confirming insurance benefits for prescribed drugs. Our team provides proper coding for all prescriptions issued and files claims for reimbursement to the applicable insurers without delay. This process can be intricate yet effective to minimize the claim denial rate and to maximize the reimbursement rate to keep your pharmacy’s cash flow stable.
Controlled Substance Billing
Controlled substance billing incurs several issues as one needs to consider federal and state laws to fill proper permits. We guarantee that our specialized services meet these regulations while dealing with the complexities that come with billing for controlled medications, including documentation and abuse.
Compounding Pharmacy Billing
Billing is another notable issue for compounding pharmacies because most of the drugs prepared by the pharmacy are patient-specific in terms of dosages and formulations. We are able to offer customized billing strategies for compounded medications, including handling coding challenges, managing prior authorization when required, and paying close attention to payers’ rules for these specialized services.
Medicare and Medicaid billing
Our consultants are well-versed in the various billing procedures of Medicare and Medicaid services. Our services cover the filing of essential documents and compliance with the specific requirements of the stated programs to make sure that your pharmacy is reimbursed appropriately for services that you offer that are covered by the program.
Prior Authorization for Specialty Medicines
Adjusting prior authorization for high-cost specialty medication itself is a very challenging and lengthy process. We oversee this process by completing and submitting all necessary paperwork to the payers and promptly following up on the submitted documents to avoid any unnecessary long waiting periods for the patient to access the needful therapies.
Billing for Immunization Services
Some of our services to clients include undertaking the billing of immunization services delivered through pharmacies. To protect against discrepancies in the claims submitted for vaccine administration and fees that accompany such vaccinations, we facilitate accurate claims for reimbursement for such basic healthcare needs.
Medication Therapy Management (MTM) Billing
We bill the medication therapy management (MTM) services provided by pharmacies. Our team makes sure that these clinical services are billed correctly and reimbursed to pharmacies for the valuable patient care they offer.
Benefits of Our DME Medical Billing Services
Taking durable medical equipment billing services from professionals like us has the following advantages for healthcare professionals.
Skilled Team:
Our highly skilled team is CMRS (certified medical reimbursement specialist) and CPB (certified professional biller) certified. Our professionals are key to your revenue cycle success.
Customer Service:
A 24/7 rapid response customer service is ready to answer all the patients’ queries. Efficient virtual patient help desk uses multiple modes of communication for patient satisfaction.
Custom Reporting:
Advance analytics reporting is provided to private practices and large healthcare facilities. These reports provide insights and performance metrics for better decision making.
One Stop Solution:
We offer a multitude of medical billing services under one roof. Additionally, our team is the industry's best—providing solutions to more than 60 medical specialties.
Categories of DME Billing Services We Work On
Mobility Aids
Personal Care Aids
Prosthetic Limbs
Orthotics
Oxygen Equipment
Why Choose Philadelphia Medical Billing Services for your Pharmacy billing?
- Our pharmacy billing staff comprises personnel, with over 95% of them having specialization in pharmacy billing laws to ensure that every claim is legal and correct.
- Our billing services are perfect for all types of pharmacies, including retail chains, compounders, and specialty pharmacies, securing every billing aspect 100% for you.
- Clients report an average revenue increase of 20-30% within the first year due to our efficient management of pharmacy claims and our focus on maximizing reimbursements for medications.
- With our pharmacy billing software, we can track claims in real-time, resolving 90 percent of problems before they result in denials and facilitating timely reimbursement for dispensed drugs.
- With dedicated account management, 98% of our pharmacy clients express satisfaction with our personalized support, allowing for quicker responses to billing inquiries and issues.
- Our compliance-oriented strategy helps to mitigate audit risks at 75%, ensuring all payer practices correspond to the current legislation and standards.
- We enhance patient care by facilitating clear communication regarding medication costs, with 85% of patients appreciating the transparency in their billing statements.