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The prescription claims process significantly contributes to unnecessary, and avoidable, costs. It is critical for every LTC pharmacy business owner to have a system in place to catch and correct errors in claims before they are submitted, enabling the prevention of payer rejections and under-reimbursements while achieving workflow improvements and protecting revenue.
Are you changing central pay providers and want to know if there is an interruption in your pharmacy cashflow? Are you thinking about changing your pharmacy's dispensing system and are worried how you will identify missing payments during the transition? No need to worry, by choosing to work with a vendor neutral reconciliation provider you will be able to identify missing payments, freeing up your time to concentrate on other operational issues during these types of transitions.
How do you identify and recover missing third-party payments and short paid or unpaid claims in the pharmacy? Approximately 95% of prescriptions are billed through a third-party payer (Number of Retail Prescription Drugs Filled at Pharmacies by Payer, 2019) for reimbursement. Payment to the pharmacy for any number of these claims can be short paid or missing which not only affects reconciliation, but negatively impacts your bottom line.
Choosing a career path in long-term care (LTC) pharmacy, especially as an owner-operator, is challenging yet rewarding for those who enter this specific segment of the profession. Often, an LTC pharmacist is also the owner-operator of their LTC pharmacy business. That means doing it all. Owner-operators wear many hats like CEO, COO, CFO, and HR, which builds upon the responsibilities already faced with caring for a long-term care patient population.
Do you find yourself wondering when will you get paid for third-party prescription claims that have been recently adjudicated?  Or how long it takes to receive payment from the Pharmacy Benefit Manager (PBM)?  Does one PBM pay faster than another?  Do your payments seem to be taking longer than normal to arrive?  As a pharmacy owner, knowing when you will be paid provides an advantage to making strategic decisions, budget forecasting, and making investments to grow your business. 
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