Magazine article Drug Topics

Pharmacy Services On-Line Claims Submission in Works

Magazine article Drug Topics

Pharmacy Services On-Line Claims Submission in Works

Article excerpt

Pharmacists agitating for pharmaceutical care reimbursement are behind a work group formed to lay the foundation for standardized electronic data submission to document services that go beyond dispensing.

The mandate given the Professional Pharmacy Services Work Group is to create a framework for the electronic documentation, storage, and transmission of clinical and billing data not related to dispensing. The work group was established by the National Council for Prescription Drug Programs, the Phoenix-based nonprofit association that works for the standardization of drug benefit administration.

The work group was formed after pharmacy leaders approached NCPDP as the best forum for addressing the issues vital to pharmacists, said Lois Upton, NCPDP communications director. The fact that about 60 people attended the work group's first meeting in November indicates the high interest in the problem of how electronic communication systems can rationally and uniformly accommodate pharmaceutical care.

"Until now, a lot of the efforts have been driven by payers," said Ken Whittemore, NARD's director of third-party program affairs, who urged NCPDP officials to facilitate the standardization effort. "This is being driven by the profession of pharmacy. Ninety-five percent of pharmacies are computerized, but there's been no way to electronically document and pay pharmacists for their interventions."

The end result of the work group's efforts should be a consensus model that will permit pharmacy providers to transmit information on services related to drug product selection, patient education, and therapeutic and compliance interventions on various levels. …

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