Pharmacy
Billing Services
Navigate the complexities of pharmacy billing with ease. Medicotechllc is here to help you with administrative burdens of intricate claim processing and compliance issues. Let us optimize your revenue cycle with accuracy, turning your billing challenges into financial success.
Difference Between Medical Bills & Pharmacy Claims
Medical bills and pharmacy claims are distinct health insurance claims with different coding systems and reimbursement methods. It’s important for patients and healthcare providers to know the difference.
Medical Bills
Eligibility and claims submission happen separately, requiring different processes.
Once submitted, medical claims cannot usually be reversed.
Medical claims use the X12 pathway for electronic submission.
They cover services like doctor visits, surgeries, and diagnostic tests.
They rely on CPT and HCPCS codes to describe procedures and services.
Pharmacy Claims
Claims are processed in real time, giving immediate results.
Pharmacy claims can be reversed to allow corrections.
Pharmacy claims use the NCPDP® pathway for secure processing.
They cover prescription drugs and related services.
They use National Drug Codes (NDC) to identify specific medications.
Types Of Pharmacy Billing Services We Offer
- Retail Pharmacy Billing: Don’t let PBM audits and DIR fees impact your profitability. Let us handle it and ensure accuracy.
- Hospital Pharmacy Billing: Handling inpatient and outpatient claims can be challenging, Partner up with Medicotechllc for seamless billing experience.
- Specialty Pharmacy Billing: Prior authorizations and patient assistance slow down specialty pharmacies. We ensure accurate billing for high-cost claims.
- Mail-Order Pharmacy Billing: Overcome shipping and refill challenges. Our mail-order pharmacy billing ensures accurate 90-day claims reimbursement.
- Long-Term Care Pharmacy Billing: Long-Term Care billing is complex due to changing payer status and Medicare requirements. We handle Part A, B, and D billing, ensuring accurate claims.
What Does Medicotechllc Cover in Pharmacy Medical Billing?
Government Plans Billing
Feeling bogged down by the ever-changing rules of government plans? Medicotechllc lifts that weight. We navigate Medicare Parts A, B, and D, and help patients benefit from the Medicare Prescription Payment Plan (MPPP) while simplifying billing for your pharmacy.
Commercial Insurance
We are here to help your pharmacy efficiently capture every dollar legally owed from major insurance payers like Aetna, Cigna, and UnitedHealth Group, transforming a complex and frustrating process into a predictable revenue stream.
Emergency Services
Facing revenue loss from complex STAT orders and after-hours billing? We handle these urgent claims with the correct place of service codes, ensuring your emergency pharmacy services are fully and promptly reimbursed.
100% Compliance With Pharmacy Billing Guidelines
Data security and compliance are the biggest concerns for providers, but with Medicotechllc, you don’t have to worry. We are a HIPAA-compliant pharmacy medical billing company. Our professionals are trained in the latest ICD-10, CPT, and HCPCS regulatory standards to ensure your claims are processed without denials or delays. For added security, we comply with PHI (Protected Health Information) regulations to safeguard patient data and PCI DSS standards for secure payments.
Efficient Out-Patient & In-Patient Handling
For out-patients, one major issue is ensuring accurate billing for medications prescribed during visits, often involving multiple insurance plans or co-pays. In contrast, in-patient billing is more complex, with providers struggling to track and process charges for various treatments over extended stays. Both scenarios require detailed attention to avoid costly errors. Medicotechllc is just the solution you’re looking for. We are professionals with years of experience. You can trust us with your bills, helping you reach the revenue heights you’re aiming for.
Pharmacy Medical Billing Services
Pharmacy Medical
Billing
Submitting and managing accurate insurance claims for pharmacy-provided medications and services.
Pharmacy Coding Services
Accurate medical coding for pharmacy specific services, prescriptions, and medical supplies.
Providers
Credentialing
Get faster verification and enrollment of pharmacists and pharmacies with insurance networks.
Pharmacy Revenue Cycle Management
By automating patient intake, verifying eligibility, and submitting claims, we deliver optimized pharmacy RCM.
Patient Statement & Collections
Clearly designed statements improve patient payments, reduce inquiries, and increase overall satisfaction.
Healthcare Verification Services
Ensuring flawless eligibility and benefits verification for seamless patient financial experiences.
Experts In Handling Pharmacy Out-Of-Network Bills
Pharmacy Out-of-Network Bills pose challenges, such as denied claims due to inaccurate payer information or coverage coordination errors. Another issue is managing multiple insurance plans and varying co-pays. At Medicotechllc, we specialize in accurate claim submission, handling coverage disputes, and resolving payer rejections swiftly. Our team ensures proper U&C pricing and effective rebilling, for timely reimbursements and reducing delays.
Claim Rejected? Don't Worry, We're Here to Help
Medical billing denials are inevitable, but they don’t have to be a major problem. At Medicotechllc, we work hard to get your claims paid on the first submission. When a claim is denied, our expert team steps in. We identify the root cause, fix any errors or missing documentation, and submit appeals promptly. Through continuous follow-up, we make sure you get every dollar you’re owed.
Outsourcing Pharmacy Billing Benefits
Outsourcing pharmacy revenue cycle management brings cost savings, efficiency, and peace of mind. Providers no longer need to handle hiring, training, or day-to-day billing hassles. A professional billing company ensures accuracy, compliance, and faster reimbursements.
- Lower Costs – No hiring, training or managing staff.
- AR Management – Faster payments, fewer denials.
- EHR/EMR Integration – Error-free, audit-ready records.
- Secure Services – EFT, EDI & ERA for quick deposits.
Pharmacy Billing Specialist A Call Away
Choose Medicotechllc and gain a dedicated account manager of your own who will communicate, listen to your problems, and solve them promptly. This personalized partnership ensures a single point of contact for all your needs, streamlining communication and leading to faster, more effective solutions.
Frequently Asked Questions
How can Medicotechllc improve my pharmacy's billing process?
Medicotechllc streamlines your pharmacy’s billing by handling complex claims, ensuring accuracy in coding, and optimizing the revenue cycle. Our team ensures faster reimbursements, fewer denials, and full compliance with current regulations.
What makes Medicotechllc different from other pharmacy billing companies?
We specialize in a wide range of pharmacy billing services, from retail to specialty pharmacy billing, with a focus on government and commercial insurance claims. Our experts provide personalized support and ensure that your pharmacy receives every dollar it’s owed.
How do you handle claim rejections or denials?
Our team identifies the cause of denied claims, corrects errors, and submits appeals promptly. We follow up continuously to make sure claims are reimbursed fully and in a timely manner.
Are your services HIPAA compliant?
Yes, Medicotechllc is fully HIPAA-compliant, ensuring the highest levels of data security and patient confidentiality in all of our pharmacy billing services.