Pharmacy and Insurance Liaison

Pharmacy and Insurance Liaison

Our team of health experts specialize in pharmacy billing. We are quickly able to distinguish which orders, appointments and invoices are subject to reimbursement. Our services include claim preparation, submission, data entry, administration activities, follow-ups, audits and assist our clients in improving their overall efficiency of the pharmacy. We cater to all pharmaceutical and medicine process management from hospitals to home care prescriptions. Our in-depth knowledge and experience of providing liaison services between pharmacy and insurance companies as made us a true one-stop shop for pharmacy billing.

Pharmacy and Insurance Liaison Services:

  • Daily Census Updates. Our team knows the importance of maintaining an updated database from the 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.
  • Admissions. We process all the admissions for our clients as it 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. Our 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.
  • Refills Management. Refill management is another area that requires great attention and quicker actions to ensure our clients customer service is top notch. We assist our clients in setting up all the necessary approvals and reminders, so that when a customer comes in for a refill, it will be processed right away without any delay.
  • Accounts Receivable Follow-Up. Our team of accounts receivable stays on top of our clients service to ensure each and every bill is paid and properly documented. The most important aspect of this service is to ensure that only the services performed are captured and billed at the right time.
  • Payment Posting. We are able to automate this labor intensive activity in for our client’s pharmacy billing. We assist in streamlining the manual payment postings, automatically post the insurance payments, and also reduce the data entry time for the pharmacy.
  • Our team of experts does not just include medically trained professionals. We have certified accountants and finance professionals who also have a working knowledge of handling medical business processes. Together they are able to efficiently handle all tasks involved with pharmacy billing for our clients including:

    • Ensuring all documentation needed is completed prior to authorization
    • Handle all billing services with insurers such as Medicare Part D and State Medicaid plans and other commercial insurances after carrying out eligibility verification
    • Provide real time updates to our clients for Medicare Part D and Medicaid eligibility requirements and changes
    • Provide customized billing statements to clients specifications that are created, stored and accessed via cloud services
    • Create streamline manual payment postings
    • Review and process authorization requests

    With a creative mix of advanced technology, industry experts, accountants and billing professionals, we develop solutions that increases our clients billing payment statistics and overall customer service in dealing with prescriptions.

    Send us your requirements and we will provide you a no cost quote.