Pharmacy Billing Services

Is your Pharmacy’s Billing process causing delays and headaches? Let our comprehensive billing services handle the details, from claim submission to denial management, and watch your revenue improve effortlessly.

Pharmacy Billing Specialist in Connecticut

At Connecticut Medical Billing Services, we appreciate that pharmacy billing is a niche service area, and reimbursement of third parties is not a simple task. It calls for extensive industry knowledge on legal frameworks, insurance forthcoming standards, and changing billing norms. Our pharmacy billing services aim to unclog the haze to enable timely claim submission with maximized reimbursements for your pharmacy. We employ our team of highly experienced billing personnel to ensure that you receive tailored services that suit the needs of your pharmacy.
Whether it is prescription billing or denial management, we keep things running smoothly so you can attend to your patients—we take care of the nitty-gritty of billing regulations, revenue cycle management, and payment collection. If you want your pharmacy to be financially sound as well as meet all regulatory requirements, you can rely on us.

Our Comprehensive
Pharmacy Billing Services

At Connecticut Medical Billing Services, we pride ourselves on providing comprehensive pharmacy billing services to suit your needs. Our services are customized to support and streamline billing operations and let you concentrate on providing exceptional patient care. Here’s how we can help:

Prescription Claim Submission

Prescription claims are processed and submitted correctly at the right time to minimize denials and monitor timely reimbursements.

Insurance Verification

The identification of the client’s insurance status, entitlements, and deductibles to avoid issues relating to rejected claims due to wrong information fed into the system.

Prior Authorization

Evaluating the prior authorization workflow to facilitate timely reappraisal and claim approvals while minimizing interference with patient care.

Denial Management and Appeals

Management of denied or rejected claims for quick action and appeals to regain lost revenues.

Audit Preparation and Support

Offering written and documented submissions for pharmacies’ audits to ensure you meet legal requirements and do not face fines.

Revenue Cycle Management

Continuous support in the different stages of the revenue cycle, from claim submission, claim payment, invoicing, account receivables, and payment posting.

Complete Pharmacy Billing Solutions Tailored for Your Practice

All of the pharmacy billing needs are served at Connecticut Medical Billing Services, making our services comprehensive for the management of your pharmacy’s financial aspect. We provide expertise in:

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Prescription Billing

We process the proper filing of prescription drug claims, particularly in accordance with current coding protocols.

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Third-Party Billing

We work with a variety of insurance companies, Medicare, and third-party providers to ensure that they render payments promptly.

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Medicare Part D & Medicaid Billing

Government-specific billing services to help practices meet Medicare Part D and Medicaid guidelines.

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Medicare Part D & Medicaid Billing

Government-specific billing services to help practices meet Medicare Part D and Medicaid guidelines.

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Compounded Medication Billing

Billing for compound medication specifically for precise coding, which helps in avoiding denial of the billing.

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Durable Medical Equipment (DME) Billing

Complete billing services of those pharmacies that offer DME to patients and help in adherence to DME billing rules.

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Specialty Drug Billing

Professionally executing the claims processing of specialty drugs and associated complicated billing for expensive therapies.

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Prior Authorization Management

We are responsible for the prior authorization process to avoid delays and confirm coverage before services are rendered.

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Pharmacy Benefits Manager (PBM) Coordination

Maintenance of submitted claims with constant oversight, as well as the management of denied or underpaid claims.

Benefits of Hiring Us for Your Pharmacy Billing

Improved cash flow due to shortened reimbursement cycles and decreased chance of claim rejections.

Knowledge and experience in the various code requirements of pharmacy billing regulations.

Fewer claims’ errors and rejections in the first place, and improved overall claim submissions.

Saving time on paperwork and other clerical needs so that there are more hours in the week to spend with patients.

Reduced average time to collect payments with integrated, efficient invoicing and payment tracking mechanisms.

Effective denial identification and appeals to help the medical practitioners reclaim their lost revenue.

Enhanced compliance with Medicare, Medicaid, and private insurance requirements.

100% open book policy with fully documented accounts and tracing of all expenses.

Consulting services that depend on the individual requirements of your pharmacy.

Our Nephrology Billing Services for Nephrologists

At Nephrology Billing Services, our professional team understands the complex world of nephrology care and billing processes, making sure they run efficiently, accurately, and are compliant. Let us support your practice:
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Dialysis Billing

We specialize in meeting the complex billing requirements associated with both in-center and home dialysis treatments and ensure all services are coded accurately and submitted on time, reducing claim denial risk while optimizing reimbursements.

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Chronic Kidney Disease (CKD)
Management Billing

Chronic kidney disease requires ongoing care that requires precise billing. Our services ensure every aspect of CKD management, from routine check-ups to specialty treatments, is invoiced appropriately so you get full compensation for the services rendered.

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Renal Transplant Billing

Billing for renal transplants can be complex, involving various steps and providers. Our experienced team oversees every aspect of billing a transplant, from pre-transplant evaluations through postoperative care, to ensure all services provided by providers are captured and reimbursed efficiently.

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End-stage Renal Disease Billing

We specialize in billing for end-stage renal disease treatments such as dialysis and other necessary services relating to end-stage renal disease, adhering to all relevant regulations with precision.

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Nephrology-Specific Coding

Our team is well versed in nephrology-specific coding, guaranteeing all procedures from biopsies to vascular access management are coded accurately—this reduces errors and increases chances of full reimbursement.

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Denial Management and Appeals

Our services are designed to grow with your practice, whether that means adding new providers, expanding services, or increasing patient volume—provide seamless integration into practice management systems to maintain continuity and efficiency while your practice evolves.

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Revenue Cycle Management (RCM)

Our comprehensive RCM services encompass every stage of the billing process, from patient registration to collection of final payments. Our focus is optimizing revenue cycles while ensuring timely payments for maximum financial health for your practice.

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Compliance and Regulatory Support

Nephrology billing must comply with stringent regulations, so we stay current with changes to healthcare laws to ensure your billing practices are fully compliant and protect you against legal risks.

Tailored Solutions for Diverse Internal Medicine Subspecialties

At Connecticut Medical Billing Services, we understand that no two practices are identical—that's why our tailored billing solutions can meet each subspecialty within internal medicine's unique demands.

Cardiology

Accurate billing for cardiovascular diagnostics and procedures.

Endocrinology

Sophisticated billing for endocrine disorders with comprehensive treatment plans.

Gastroenterology

Precise billing of all gastroenterological procedures with exceptional care plans.

Pulmonology

Offers expert billing for respiratory care and chronic lung conditions.

Nephrology

handles dialysis management and kidney disease management.

Rheumatology

Covers comprehensive billing for autoimmune disorder care as well as arthritis management.

Geriatrics

Customized billing tailored specifically to the care of elderly patients.

Infectious Disease

Utilizing specific billing services dedicated to treating and diagnosing infectious disease conditions.

Get Started with Expert Pharmacy Billing Today!

Are you ready to take your pharmacy billing to a whole new level and increase your revenues? Get in touch with Connecticut Medical Billing Services today for your free consultation and let our solutions enhance your practice.

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