Magazine article Drug Topics

Tips on How to Collect

Magazine article Drug Topics

Tips on How to Collect

Article excerpt

When it's time to be paid for home care services, your claims can be seriously tangled up in bureaucratic red tape. J. Scott Reid, Pharm.D. and president of Sutherland Associates Inc., an alternate-site health-care delivery consulting firm in Glen Allyn, Ill., has some advice:

Medicare: To be reimbursed, a pharmacy must be a certified Medicare provider under Medicare Part A, which covers claims for Part B. And different provider numbers are needed to submit claims for different services. "Make sure you have all the proper claim numbers," Reid said. Think the check will come right to you if you deal with Medicare on an assigned basis? Not necessarily. The four regional offices that process Medicare Part B claims use local carriers, so payment policies can vary from state to state. Make sure you know in advance whether you will be paid directly.

Medicaid: The important factor in dealing with Medicaid is an up-to-date state pharmacy license. …

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