This is a question we’ve heard too many times from too many pharmacists.
The short answer: Yes!
The long answer: Yes, and we’ll help you get started today!
50% of Medicare enrollments are Medicare Advantage plans that require direct contracting.
If you are looking to provide clinical services to your non-Medicare population you will need to contract directly with commercial payers in your area. This requires two key steps:
● Contracting – A complex and lengthy process that requires a significant documentation burden and 3 to 6 months of waiting and negotiations before getting in-network approval.
● Credentialing – A process of engaging a credentialing database that must be consistently maintained throughout the year. Any lapse in the maintenance of this database will lead to being removed from in-network status for all payers, stopping reimbursements and requiring the contracting process be initiated all over again.
Provider CSAO is the first organization to execute and manage both sides of this process for pharmacists. We'll arrange the contracts and credentialing, then manage them for pharmacists so that they can focus on their services to patients.
Provider CSAO has pharmacies in its network getting reimbursed for services like:
● MTM
● PGx testing
● Vaccinations
● Diabetes testing/ continuous glucose monitoring
● Medical devices
● And more
To learn more and grow your clinical services and medical billing visit ProviderCSAO.com
Provider CSAO is a credentialing & contracting service for pharmacies (independent, hospital, clinic, and other). We work on behalf of our clients to contract and become in-network with medical benefit insurance payers and negotiate reimbursements on their behalf. We strive to help pharmacies expand in clinical services while being reimbursed as providers to better serve their communities and improve healthcare accessibility across America.
This post is related to:
Community / Retail Pharmacy Resources PSAOs, Revenue Cycle Management, Reconciliation
