Pharmacy Billing Services
Streamline Your Revenue Cycle with Expert Pharmacy Billing
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At Modern Medical Billing, we recognize the unique challenges that pharmacies face in managing their billing processes. From handling high-cost medications to navigating complex insurance requirements, our dedicated team is here to help you optimize your billing operations, ensure compliance, and maximize your revenue.
Why Choose Our Pharmacy Billing Services?
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Industry Expertise: Our team specializes in the intricacies of specialty pharmacy billing, ensuring that your claims are processed accurately and efficiently.
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Comprehensive Billing Solutions: We provide end-to-end billing services tailored specifically to the needs of specialty pharmacies, from prescription verification to payment posting.
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Insurance Coordination: We handle the complexities of insurance verification and authorization, ensuring that your patients receive the coverage they need while you receive prompt reimbursement.
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Accurate Coding: Our experienced coders are proficient in using the latest NDC, HCPCS, and CPT codes relevant to specialty pharmacy services, reducing the risk of denials.
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Compliance Assurance: We ensure that your billing practices adhere to all relevant regulations, including HIPAA, Medicare, and Medicaid requirements.
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Dedicated Support: Our client support team is available to assist you with any billing questions or concerns, providing you with peace of mind.
Our Pharmacy Billing Process
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Prescription Verification: We verify patient prescriptions to ensure accuracy and compliance with insurance requirements, reducing the likelihood of claim rejections.
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Insurance Authorization: Our team manages the insurance authorization process, securing the necessary approvals for high-cost medications.
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Billing and Coding: We accurately code and submit claims, using the latest billing software to streamline the process and reduce errors.
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Claim Submission: We submit claims electronically, ensuring quick processing and faster payments.
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Payment Posting: We post payments promptly and accurately, giving you a clear picture of your revenue cycle.
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Denial Management: Our team proactively addresses claim denials, working to resolve issues quickly and recover lost revenue.
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Reporting: We provide detailed reports on your billing performance, offering insights that help you make informed decisions about your pharmacy operations.
Benefits of Partnering with Modern Medical Billing
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Increased Revenue: Our expertise in pharmacy billing helps you capture more revenue by reducing claim denials and improving reimbursement rates.
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Enhanced Efficiency: We handle the billing process from start to finish, allowing you to focus on patient care and other critical aspects of your business.
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Improved Cash Flow: Our efficient billing and coding practices ensure faster payments, improving your pharmacy’s cash flow.
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Regulatory Compliance: We stay up-to-date with the latest regulations, ensuring that your billing practices remain compliant and avoiding costly penalties.
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Personalized Service: We tailor our billing services to meet the unique needs of your pharmacy, providing customized solutions that drive results.
Why Our Clients Trust Modern Medical Billing:
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Collection Success of Up to 98%: Maximizing revenue with consistent, high collection rates.
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Cost-Effective Billing: Starting at just 1.99% of collections for a full-time dedicated billing and coding team—well below typical wage costs.
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Streamlined Operations with Automation: Enhanced workflows through cutting-edge automation technology for greater efficiency.
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Fast Turnaround Times: Claims processed and submitted within 48 hours or less.
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Exceptional Billing Accuracy: Precise billing practices that minimize errors and delays.
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Proactive Cash Recovery: A forward-thinking approach to ensuring timely cash collection.
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Thorough A/R Follow-Up: Comprehensive follow-up measures until every outstanding claim is resolved.
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Complete HIPAA Compliance: Ensuring the highest level of data protection and privacy.
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Substantial Cost Savings: Proven to reduce billing costs by up to 80%.​​​
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Personalized Support: Dedicated account managers offering full-cycle support from start to finish.​​​
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Flexible Agreements: No long-term lock-in periods—our service is designed to adapt to your needs.
Our Comprehensive Services
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Medical Coding: Accurate, up-to-date coding for all physician services.
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Patient Demographics & Eligibility Verification: Ensuring accurate data entry and eligibility checks.
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Charge Entry: Efficient fee schedule management and charge entry.
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Claims Submission: Prompt submission of clean claims to payers.
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Patient Billing Statements: Timely creation and mailing of patient statements.
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Payment Posting & Reconciliation: Accurate payment posting and reconciliation of charges.
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Denial Management: Swift resolution of denied claims to recover lost revenue.
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Claims Resubmission: Fast corrections and resubmission of denied or rejected claims.
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A/R Follow-Up: Persistent follow-up on outstanding payments to ensure timely collections.
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Claim Closure: Proper closure of claims when the balance is fully settled.
Get Started Today
Don’t let the complexities of pharmacy billing slow down your revenue cycle. Partner with Modern Medical Billing for expert billing services that simplify your operations and boost your bottom line. Contact us today to learn more about how we can support your pharmacy.