Specialty Pharmacy Billing Services Tailored for Precision and Compliance
Medical Billing for Specialty Pharmacy
- Seamless & Perfect Billing Support
Medical Billing for Specialty Pharmacy - Seamless & Perfect Billing Support
Compliant, Accurate, Timely Billing for Specialty Pharmacies
Specialty pharmacies serve patients with complex and chronic medical conditions through supply of specialty medications to treat rare or complex health conditions. As these pharmacy manages rare, chronic, and often complex medical conditions, it requires an increased level of patient management, specific dosing guidance, and counseling.
Because of the complexities of services and high cost of specialty medicines, it is imperative to manage reimbursement process efficiently. The complexities of the medical billing world make billing for clinical care difficult for many pharmacies. RCM Workshop’s billing services for specialty pharmacies assist you manage the complexities and challenges in billing efficiently, and get the appropriate reimbursement for your services. With a thorough and in-depth knowledge of operations workflow for specialty pharmacy coupled with our standardized medical billing process, our pharmacy billing experts add exceptional value at every stages starting from coverage determination, prior authorization to billing submission and collection.
Unbeatable Service, Quality & Price
OUR PROCESS
Our Specialty Pharmacy Billing Process Workflow
Our billing experts work diligently and follow industry–standard best practices for revenue cycle management to minimize errors and reduce claim rejection rates, resulting in better turnaround time and higher revenues for your practice. Our efficient process for denial management and AR follow-up ensures timely payment and eliminates payment delay. Our KPI metrics driven reporting tool captures and reports every aspect of process performance – productivity, quality and $ collections in a transparent way and gives you full control over your billing process.
Order Intake
Eligibility & Benefits Verification
Prior Authorization
Code Review & Audit
Charge Posting
Claims Edit & Submission
Payment Posting
Denial Management
AR Management
Patient Collection
BEST PRACTICES
Our Specialty Pharmacy Billing Best Practices
- Thorough and accurate benefits verification and coverage determination
- Effective and faster prior authorization process
- Efficient denial management and prevention of denials
- Proactive and meticulous claims follow-up with payers
- Accurate payment adjustment, write-off and reconciliation
- Stringent quality audit at every stage of billing cycle to ensure accuracy
BENEFITS
Outcomes guaranteed
Our specialty pharmacy revenue cycle management process is backed by data analytics and metrics-based operation strategy to help optimize your billing process and ensure a superior quality outcome consistently. We assure you a much-improved financial outcome – maximized revenue, steady cash flow and reduced operational costs.
Efficient insurance verification
>99% clean claim submission
Efficient authorization management
<24 hours turn-around time
Efficient coding & code review
>25% increased reimbursement
Efficient denial management
<5% claims denials
Proactive accounts receivable follow-up
<40 days AR & reduced aging
Better coordination & documentation
improved revenue cycle
WHY US?
Why partner with us
Our revenue cycle service encompasses all facets of your specialty pharmacy billing needs, seamlessly integrating into your existing billing infrastructure. By following medical billing best practices and protocol for quality assurance and compliance, our dedicated team provides a superior and improved billing service. We are committed to delivering unparalleled support and productivity, while helping you optimize your revenue cycle. Outsource specialty pharmacy billing services to us today for exceptional outcomes and transform your billing process.