Pharmacy Billing

People make many common mistakes regarding pharmacy billing, but if you want to know how to avoid them, read on.

There are five main reasons people make mistakes regarding pharmacy billing: distractions, interruptions, corporate greed, a lack of regulation, and medication misuse.

Read on to learn more about why you may be making these mistakes. If you are a pharmacy owner, you should be able to spot them in no time.

5 Common Pharmacy Billing Mistakes

#1. Distractions

Many pharmacists say the constant distractions they face in their work distract from the work they’re supposed to be doing.

The continual need to fill orders made it impossible to meet the metrics and ensure patient safety. Pharmacists had a 700-order backlog in one store, working overtime to catch up.

The workload was so heavy that they could barely take a break during the day. Distractions can lead to a lapse in patient care and quality care.

The impact of interruptions on patient safety is well documented. For example, distracted drivers are three times more likely to cause an accident than those who drive without cell phones.

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Distractions can also lead to the inability to concentrate, which means they can’t deliver quality care.

Distractions can occur in any setting, from driving to caring for a sick person. While they may not sound like a big deal, they have devastating consequences.

#2. Interruptions

Pharmacists’ role in pharmacy billing varies and includes handling customer requests, performing triage tasks, and engaging in non-work-related conversations.

While pharmacists typically take the initiative to avoid these interruptions, they often end up causing them. The following are some ways pharmacists can reduce interruptions in pharmacy billing.

Let’s examine each of these in turn. Pharmacy employees should be trained appropriately to avoid interruptions, differentiate between tasks, and ensure they are not interfering with pharmacy operations.

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First, pharmacists must consider the source of interruptions. There are many reasons for interruptions, including patient concerns, self-initiated interruptions, or technological problems.

These interruptions may increase the risk of error by distracting pharmacists and technicians from their work.

For example, disruption during patient appointments will likely result in a dispensing error. Second, interruptions may occur due to the creation of another pharmacist.

To reduce interruptions, pharmacists should use technology and better staff training.

#3. Corporate greed

We all know that pharmaceutical companies are usually linked with corruption, but do we understand how corporate greed affects our healthcare system?

Last year, CVS’s CEO received $36.5 million in compensation. And that’s not including the millions paid to lawyers and Wall Street bankers.

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The biggest drug companies have even gone into debt to make money, and the profits are being distributed as stock buybacks and cash dividends. Yet, the price of pharmaceuticals continues to rise.

The term “corporate greed” is shorthand for the criticism of contemporary capitalism. While corporate critics see the unbridled greed of companies, business-friendly Democrats see the unremarkable workings of supply and demand.

In 2017, drug companies spent $6.1 billion marketing their products to consumers. It’s simply not fair for them to be making profits out of the marketing process. Yet, drug companies have pushed prices by as much as 50 per cent.

#4. Lack of regulation

Despite efforts by lawmakers and health insurers, the pharmaceutical industry lacks adequate regulation to protect patients from the unfair practices of pharmacy benefit managers (PBMs).

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For example, state law does not allow PBMs to impose a mandatory minimum price for their products. Many PBMs use “clawback” laws to get more money than they should.

While these laws may seem good for consumers, pharmacists are frustrated by the high costs and lack of transparency.

Despite the high cost of prescription drugs, manufacturers have blamed other parts of the supply chain for skyrocketing prices. But the real culprits are PBMs.

Instead of attacking manufacturers, legislators should look at these companies and the PBMs themselves.

They have enormous influence over what medicines and price range people can afford. But there are some steps lawmakers can take to protect patients.

#5. Medication misuse

Medication misuse can occur innocently or escalate to dangerous levels of prescription drug abuse. The most common prescription drugs abused are opioids, central nervous system depressants, and stimulants.

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These drugs can cause overdose, addiction, or even ER visits when taken improperly. Pharmacy staff can play an essential role in preventing prescription drug misuse by monitoring prescriptions, filling them appropriately, and watching those who supply them.

If a pharmacist suspects a patient may be abusing a prescription, they must follow valid prescription laws.

If they discover a pattern of medication misuse, they should inform the DEA, state, or local authorities and seek additional information. Alternatively, a pharmacist can refuse to fill a prescription if they suspect it is abused.

In both cases, a pharmacist should contact the patient’s prescriber and seek further information if the suspicion is justified.