The Nuts and Bolts of Billing for Pharmacists’ Services - Opportunities and Challenges
John Gums, PharmD, FCCP - Professor and Associate Dean for Clinical and Administrative Affairs - and Eric A Dietrich, PharmD, BCACP, CPC-A, CEMC, CPB - Clinical Associate Professor from the University of Florida College of Pharmacy talk with us about billing for pharmacy services.
Key Lessons:
A sustainable clinical practice model is formulated by creating a business plan that considers the services to be provided as well as reasonable estimates of the number of patient encounters, the duration for each patient encounter, billable revenues, collections, and costs.
Evaluation and Management (EM) codes are used to bill services. The complexity of the patient encounter characterizes the "level" of service, ranging from level 1 (minimal complexity, self-limiting problem) to level 5 (High, Chronic Conditions, Severe Exacerbation, Disease Progression).
Comprehensive medication management services provided by pharmacists are typically billed by a recognized provider (physician / nurse practitioner) using an "incident to" billing method.
Pharmacists can also bill for transitional care management (TCM), chronic care management (CCM), and annual wellness visits (AWV) - but each of these services must meet specific conditions and requirements under Medicare Part B.
Learning to speak the language of billers and coders is critically important.
Consider training or certification through the American Academy of Professional Coders (AAPC)
There is a significant difference between what is billed and what is collected.
Pharmacists should track their time, number of patient encounters, billable units of services, and collections to determine if their initial estimates are correct. When there are discrepancies, determine the sources and address the causes.
Check out these guidelines and resources on how to develop a business-practice plan and bill for pharmacists' patient care services:
American College of Clinical Pharmacy (ACCP) - Developing a Business-Practice Model for Pharmacy Services in Ambulatory Care Settings
American Association of College of Pharmacy (AACP) - Integration of Clinical Pharmacy Faculty in Professional Practice Care Settings
National Council for Prescription Drug Programs (NCPDP) - Billing Guidance for Pharmacists' Professional and Patient Care Services
15 Feb 2022
Time for a Change? Approaching a Career Pivot with Confidence
Lucinda L. Maine, Ph.D., R.Ph. - Executive Vice President and Chief Executive Officer of the American Association of Colleges of Pharmacy - talks with us about how to manage major career changes and why a degree in pharmacy is so valuable.
Key Lessons:
Career pivots can be welcomed and sought ... or arise from something unexpected and unwanted.
Most professionals will experience several major career changes during their working years.
A pharmacy degree enables a surprisingly broad range of career paths.
Being prepared for new opportunities by continually updating your knowledge and skills is critical.
Having the financial resources available to obtain additional education, training, or experience is an essential career insurance policy.
Active engagement in professional pharmacy associations, at both the state and nation level, provides a great way to network and keep current with the latest trends.
Many people, especially women, are reluctant to make a major career change without having "all the necessary" credentials and experiences. But consider what is essential ... you can learn the rest on the job.
Several resources are available to help you explore the career options that align with your strengths, skills, and interests:
Check out the American Pharmacists Association Career Pathway Evaluation Program and ADVANCE for continuing professional development
AACP-APhA Pharmacy Opportunities Network (PharmON)
17 Jan 2022
Crushed by Stressors: Cultivating Healthy Responses
Cynthia Knapp Dlugosz, BSPharm, NBC-HWC - Solopreneur and Owner of Being in Balance Coaching and Artemis Health Care Communications - and Elizabeth Buckley, PharmD, CDCES - Professor, Department of Pharmacy Practice, Concordia University Wisconsin — talk to us about threats to our well-being and self-care practices.
Key Lessons:
We are surrounded by stressors that adversely impact our sense of well-being.
The ubiquitous use of technology has increased the demands on our attention.
The pillars of well-being based on research from the Center for Healthy Minds at the University of Wisconsin-Madison are: Awareness, Connection, Insight, and Purpose.
Much of our dissatisfaction and psychological suffering stems from our desire to push away or change the unpleasantness in our lives.
Mindfulness is a state of being where we are attentive in the present moment with receptivity, non-judgment, and compassion with what arises.
Meditation and yoga are practices that cultivate our ability to be mindful - our ability to be more attentive, receptive, less judgmental, and compassionate.
Gratitude increases our happiness. Those with the least material wealth are often able to recognize and express gratitude for the blessings in their lives but anyone can learn to be more grateful.
Health professionals feel acutely stressed today because the environmental demands are beyond their ability to successfully cope due to unpredictability, uncontrollability, and overload.
Organizations have a responsibility to implement strategies to address the environmental demands and the underlying causes of stress.
Resources and Books:
Center for Healthy Minds, the University of Wisconsin-Madison
Brown B. Atlas of the Heart. Mapping Meaningful Connection and the Language of Human Experience. New York: Random House, 2021.
Moss J. The Burnout Epidemic: The Rise of Chronic Stress and How to Fix It. Boston: Harvard Business Press, 2021
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