Specialty Pharmacy Billing

Specialty pharmacies deal with complex medicines but these are not like regular prescriptions. The billing process is much harder as accuracy is very important. Rules are strict and the documentation must be complete to streamline the claim submission process.

Specialty pharmacies play a leading role in managing patients with chronic, complex, or rare conditions such as cancer, multiple sclerosis, and hemophilia. Since the cost of the pharmacy drug is high, a single billing mistake may result in claim denial. So, that is where the pharmacy has to bear all the associated costs.

Specialty pharmacy is a branch of pharmacy that provides medications for chronic, and rare health conditions. These conditions include cancer, rheumatoid arthritis, and multiple sclerosis.

Prior authorization always plays a significant role in your specialty pharmacy billing process as you must obtain PA approvals for most of your specialty pharmacy drugs. Always remember one thing that your PA process is not something that you can take lightly as failure to obtain prior authorization can cause your practice to see denied claims and unexpected out-of-pocket payments for your patients. Fortunately, a good specialty pharmacy billing company can make this way easier for you!