Magazine article Drug Topics

Software Puts Major Medical Claims On-Line

Magazine article Drug Topics

Software Puts Major Medical Claims On-Line

Article excerpt

A software package about to hit the market will make it easier for independent pharmacies to bolster the bottom line by going on-line with major medical insurance reimbursement claims.

By going on-line, the software will make it faster and easier to bill major medical plans for cognitive services, according to Ron Cains, who heads Pricing Systems, Ridgefield, Conn. The fully automated system doesn't require any working knowledge of procedure codes or pesky paperwork to keep the third-party pencil pushers happy. Patient information must, however, be entered using cursor movements on pull-down menus. The claims are submitted to insurers by Pricing Systems, which inserts the correct procedural codes.

"I think that pharmacies that try to make money from prescriptions will be gone in five years," said Cains. "We're going after clinical services, such as diabetes education, pulmonary therapy, home IV therapy. Right now, all pharmacies are being paid for fittings, ostomy supplies, and prosthetics. They're getting paid for products. They're not getting paid for the services, but they can. Perfectly legitimate billing to the major medical people for the services entailed is possible. …

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