Specialty Pharmacy Accounts Receivable Services

Before we come to the specialty pharmacy accounts receivable services, we should know what specialty pharmacies deal with. As the name itself suggests, a ‘Specialty Pharmacy’ provides high-cost, high-touch medication therapy to patients with rare or complex health problems. Consequently, the stakes are high regarding Specialty Pharmacy accounts receivable services. The value of collections lying unrealized is typically high, and it requires specialized and dedicated expertise to collect from such unpaid claims.

Most of the time, the medications available at a Specialty Pharmacy are not intended for general patients. This is why regular pharmacies, such as Compounding Pharmacies or Community Pharmacies, do not stock them. This is just another testimony to the somewhat exclusive nature of these pharmacies.

Billing for Specialty Pharmacy medications encompass a wide range of related services, such as:

  • Special handling by pharmacists
  • Preparation and storage of medications
  • Administering the medicine (for example, by using IV to inject or infuse into veins), and so on.

Challenges in Specialty Pharmacy Accounts Receivables and Denial Management

As Specialty Pharmacy centers deal with providing costly medications for complex health issues, unrealized collections can severely impact their financial health and disrupt the cash flow. A small amount of bad debt is natural in most cases. But letting it accumulate, is a bad idea. What usually happens is, unpaid bills lying unattended for long, get increasingly difficult to collect from, and eventually get swept under the carpet.

Let us try to understand why the situation is so grim.

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sunknowledge advantage

A Specialty Pharmacy’s fundamental objective, just like any other healthcare service, revolves around providing exceptional patient care. When it comes to Accounts Receivable for Specialty Pharmacy Practice and collections affairs, especially collecting from accounts receivable and Specialty Pharmacy Denial Management Services, with associated issues like following up with concerned Payers and patients, minimizing write-offs, managing A/R buckets, streamlining collections, and expanding payment choices – Specialty Pharmacies find it a taxing and time-consuming challenge.

Amidst these challenges, maintaining an unwavering focus on patient care becomes difficult. On the other hand, neglecting collection issues can significantly impact the business’s financial health, causing long-term detriments to cash flow.

It is a Catch-22 situation. So the question of the hour is, what is the most pragmatic solution to this unique problem?

Outsource Accounts Receivable for Specialty Pharmacy

Outsourcing accounts receivable services for specialty pharmacy practices dealing in specialty drugs, enables such practices to not only create accurate invoices timely and swiftly, completing all repetitive, but critical, tasks efficiently, but also ensure a higher collection rate through diligent follow-ups on all denials.

When it comes to simplifying the entire accounts receivable management methodology, we are your trusted partner. We have been providing cutting-edge solutions in active A/R management to healthcare practices like yours for close to two decades.

I just want to take a moment to recognize the Sunknowledge team for their high level of detail in notes when tagging invoices they are working on. They provide a high level of detail and steps taken to resolve invoices and every line item billed, far beyond my other collectors every week and I feel they deserve to be recognized

RCM Supervisor of a Leading DME Provider from Pennsylvania

No matter what the cause for denial is – be it an authorization issue, a referral issue, or an out-of-network issue – we dig deep to identify the exact reason for non-payment by regularly following up with the Payer(s) and documenting all communication accordingly, eventually arriving at a satisfactory resolution.

Unlike other players in the market, we at Sunknowledge, prioritize higher value claims and the oldest DOS (date of service), to ensure maximized collection for your Specialty Pharmacy practice.

Main Steps in Accounts Receivable for Specialty Pharmacy Practice: The Sunknowledge Way

  • Comprehensive A/R analysis where we do deep analysis on aging buckets
  • Regular follow-up with payers in every possible mode including IVR, online and communication with the insurance company representative
  • Taking corrective steps to reverse the denial
  • Successful closure of claims with maximized collection

Benefits of Outsourcing Specialty Pharmacy Accounts Receivable Services

We understand accounts receivable management like few other RCM companies out there. A large part of our success is owed to our years of experience in working directly with Payers. Understanding why denials happen, and how to reverse them, is our forte.

If you are looking for dependable Specialty Pharmacy Accounts Receivable Services & denial management, tailored specifically for Specialty Pharmacies, look no further. Only Sunknowledge assures you of…

  • Shrinking of the current A/R bucket by up to 30% within a month
  • Hands-on expertise in working with hard-to-recover aging accounts
  • More than 7 years of experience in claims adjudication for key insurance plans
  • Instant access to a vast pool of trained A/R personnel
  • Reduction of collection cost by up to 80%
  • Full remote support that works as a seamless extension to your current operations
  • Ensuring financial stability
  • Dedicated Account Manager at no extra cost
  • No binding contracts; easy 30-day exit
  • Daily/weekly/monthly reporting based on clients’ requirements

To learn more about our Specialty Pharmacy accounts receivable services, use the form below to schedule a free consultation. Let us show you how we can breathe new life into your collections.

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