Precision Pharmacy Billing with Practice Mate

For Practice Mate every prescription counts—and so does every detail of the medication. We offer a pharmacy billing management service to address the complexities. We’ve built an accurate pharmacy-focused solution for efficient prescription fulfilment and let you focus on care.

Trusted Texas-Based Experts in Pharmacy Revenue Management

Pharmacy requires precision. Every order and claim is prepared with attention to even the minute detail. This means maximizing acceptance rates and minimizing the need for resubmission. Our pharmacy billing service is fully scalable, accommodating everything from independent pharmacies to large chains with multiple locations. We adapt our approach to offer consistent support and optimized reliable billing at every stage and step of the process. Our team stays updated with the latest ICD-11 and DSM-5 standards means every claim meets regulatory requirements and reduces the risk of audits.

World-Class & Accurate Pharmacy Billing Solutions

Daily Census Updates

Real-time updates to patient records to key data changes such as discharges, physician updates, and census information because our team knows how crucial it is for maintaining accurate billing documentation.

Admissions Management

Integrated tracking of patient admissions, feeding directly into billing workflows, and everything in between. Practice mate performs immediate claims initiation to reduce delays and improve cash flow by maintaining up-to-date admissions data.

Prior Authorization Document Management

We organize storage and management of prior documents to improve the authorization process for quicker approvals. This reduces wait times on claims, allowing for faster reimbursement cycles and maintaining compliance with insurance provider requirements.

Refills Management System

Automated tracking and processing of prescription refill requests, complete with reminders and approval tracking. This service means timely and accurate fulfillment for recurring orders to minimize prescription delays.

Accounts Receivable (AR) Follow-Up

This service supports continuous AR monitoring with immediate follow-ups on outstanding accounts. This active tracking approach shortens payment cycles, improves collections, and stabilizes cash flow, and eventually improves financial health.

Automated Payment Posting

Direct integration of both manual and automated payments into the billing system. This service captures payments in real-time, reducing data entry, and delivering up-to-date financial records for simplified account reconciliation.

Claim Status Monitoring and Tracking

Real-time claim tracking from submission to final settlement guarantees full visibility over each claim’s progress. This reduces time on follow-ups and improves reimbursement timelines.

Insurance Eligibility Verification

Practice Mate offers a comprehensive pre-submission verification of insurance coverage to confirm patient benefits before claims submission. This service reduces rejections, improves claim acceptance rates, and speeds up the reimbursement process.

Our Proven Process for Reliable, Efficient Pharmacy Billing

  1. Intake and Verification
    We begin by intaking every detail  accurately, from patient identity to prescription authenticity which is verified against industry standards. Our team retrieves, verifies, and cross-checks all patient and physician credentials for compliance and negotiates costs with the manufacturer. 
  2. Data Conversion and System Integration
    All documents are scanned,  classified and integrated into your system, also converting original scans into actionable data. This digitized and gathered source of information means reduction in manual handling errors and expedites the entire billing workflow.
  3. Medication Refill Management
    Each medication refill request is correctly processed to reduce the likelihood of delays or shortages as much as possible. We assess each patient’s refill status and calculate medication quantities based on prescription duration so that the necessary approvals and reminders are set for prompt service.
  4. Customized Order Placement and Cost Efficiency
    We identify prescribed medicines by brand and suggest cost-effective alternatives where appropriate. Orders are placed directly, with timely notifications sent to insurance providers and patients, especially for high-priority emergency kits, which are processed within 30 minutes of receipt.
  5. Dedicated Order Tracking and Delivery Oversight
    Once we have everything in place, our support doesn’t stop there. Our dedicated tracking team monitors each consignment from start to finish, managing escalations in the event of logistical delays. This results in a smooth delivery process, no disruptions to patient service and keeps your pharmacy operations efficient.

Accurate and compliant pharmacy billing to minimize claim denials

01

Specialized Expertise in Pharmacy Billing

Practice Mate's team is well trained with knowledge of pharmacy-specific billing codes and regulations.

02

Proactive Accounts Receivable Management

Through continuous monitoring and prompt follow-ups on outstanding accounts, the Practice Mate certified team provides financial stability for your pharmacy.

03

Commitment to Compliance

Our team stays abreast of the latest healthcare regulations, adhere to current standards and minimize audit risks and safeguards your practice's reputation.

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