Jennifer J. Carmody
Director of Reimbursement Services
At a time when provider organizations face declining reimbursements and increasing expenditures for prescription drugs, organizations may be failing to secure millions of dollars in pharmacy revenue. Whether this revenue gap is caused by disconnects between pharmacy and financial systems or having difficulty aligning drug prices across multiple hospitals and clinics, these causes of underpayments and overpayments must be aligned for the sake of the hospital’s financial success.
Billings Clinic, an integrated delivery system with multiple branch clinics and affiliated hospitals and clinics, shares how it bridged gaps between pharmacy expense data and financial system to ensure proper pricing and billing on claims and established efficient workflows and maintenance processes. Billings Clinic identified four key success factors: fully integrating pharmacy data, regularly reviewing data to identify charge accuracy and compliance concerns, bridging price gaps, and establishing data governance workflows.
After This Webinar You Will Be Able To:
- Develop a cross-departmental partnering approach that results in improved pharmacy revenue.
- Identify disconnects between medication charges and payment received.
- Define a workflow for integrating pharmacy data with financial systems.
- Improve claims accuracy and compliance by implementing an audit plan that identifies root causes of errors.
Tools and Takeaways
- Pricing strategy options to consider when aligning drug pricing across multiple facilities
- Resources to help identify areas for improvement within pharmacy billing including automation tools
CEOs, CFOs, revenue integrity directors and managers, pharmacy directors, and chargemaster managers
Field of Study
Specialized Knowledge and Applications
HFMA members: Free
CPE hours: 1.0
Note: This on-demand webinar is available until Dec. 18, 2014.