Experience Robust Pharmacy Billing Services with Sunknowledge

It is estimated that more than 10,000 baby boomers are turning 65 each day, leaving the specialty pharmacies to absorb and deal with the challenges of “graying America” while reimbursements continue to shrink.

The pharmacy market is getting highly competitive with each passing day. It is essential for the providers to embrace the technology and business models that bring the most organizational benefit.

At the CMS, policies on reimbursements are getting tighter and more restrictive, increasing the complexities of specialty pharmacy billing services. Therefore, you must consider developing a proactive RCM approach to ensure claims are handled efficiently with little to no errors and payments are collected quickly.

The Specialty Pharmacy Billing Riddle

Within this dynamic landscape of the healthcare industry, pharmacists like you are facing the intricate challenge of managing high-volume prescription processing, necessitating the implementation of accurate and meticulous information.

Missing information or lack of adherence to regulatory compliance leaves you with claim denials and substantial revenue loss in the long run.

The prevalent manual handling of prior authorization often leads to errors. Well, managing a pharmacy prior authorization process requires a specialized skill set of knowledge and experience.

While streamlining this process is crucial, allowing you to spend your valuable time in patient care, complications within the process leave you with more administrative burden and crooked patient care quality.

Considering the niche, your independent pharmacy should offer clinical services. Among these services compounding a prescription requires careful attention and near-perfect precision.

And then there is compound billing, which is just as tedious and complex as compounding itself.

On top of this, there are numerous coding requirements within the specialty pharmacy billing process and frequent changes in coding guidelines make it more difficult for the providers to execute an accurate billing service.

Missing codes, up-coding, under coding grapple specialty pharmacies with claim rejection, reimbursement delays, and claim denials. This puts an extreme administrative burden on providers like you that often results in burnout and of course revenue loss.

By considering a third-party partner that is technologically advanced and able to provide billing and collection services as per your requirements, you ensure a healthy bottom line capable of funding necessary expansion in the future.

The Path Forward with Sunknowledge

To be a healthcare destination, your specialty pharmacy should have all its ducks in a row, and redefining the billing and coding process is a good place to start.

You might ask, “How is Sunknowledge going to help me?”

Here are some key areas where you can leverage the benefits of our industry expertise and experience-

• Managing patient records
• Creating patient demographic entries
• Prior authorization and document management
• Refill management
• AR follow-up
• Payment posting

As per your requirements, we can provide you with specialty pharmacy coding and virtual assistance to handle your practice’s administrative aspects.

With our commitment to consistent quality services, you will experience-

• Reduction of overall operational costs by 80%
• Closely monitored operations with 99.9% accuracy
• Dedicated and expert resources working as per your preferred time zones and practice requirements
• No binding contracts or restrictive clauses
• Complete pre-and post-billing services
• 10% buffer resources to sustain productivity

We have been solving revenue cycle management puzzles for numerous healthcare providers across the country for more than a decade now with excellent client references and great versatility.

To experience a well-defined end-to-end specialty pharmacy billing workflow, contact us today!