Unlike most departments, pharmacy pricing is typically not hard-coded and billed from the chargemaster. Rather it is generated on an array of variables such as drug cost, quantity, units, tiered mark-up factors, dispense fees, and more. With all these factors it’s easy for something to go wrong, and drug billing has recently been called to attention by recovery audit contractors and payers for overbilling, which has often taken place inadvertently.
In this era of scarce financial resources, financial and pharmacy managers cannot risk being blind-sided with large take-backs due to drug overbilling. In addition, your organization cannot risk unfavorable publicity due to unreasonable drug prices.
Panacea can help you overcome these challenges with a defensible pharmacy pricing strategy.
- Uncover coding and billing risks lurking in your pharmacy systems
- Reveal new incremental revenue opportunities
- Update and maintain accuracy and data integrity
- Create rational and defensible drug pricing
- Reduce risk for RAC, OIG, and payer audits
- Reduce public relations exposure