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Optimizing Third-party Reimbursement for Compounded Medications

Author(s):  McElhiney Linda F

Issue:  May/Jun 2013 - Volume 17, Number 3
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Abstract:  Recently, third-party payers have been closely scrutinizing compounded medications that are dispensed in hospital-based outpatient pharmacies. Insurance claims are being rejected for reasons that defy logic. Working with third-party payers and receiving reimbursement for compounded medications can be frustrating and complicated; however, simple measures can be taken to optimize reimbursement for the medications. This article discusses some of these simple measures.

Related Keywords: Linda F. McElhiney, PharmD, RPh, FIACP, FASHP, FACA, hospital pharmacy compounding, third-party reimbursement, health insurance claims, National Drug Code number, NDC number, flavoring agents, purified water, bulk chemicals, manufacturers, formulation modification, formulation standardization, drug costs

Related Categories: BUSINESS, EXCIPIENTS, DOSAGE FORMS/DRUG CARRIERS, HOSPITAL PHARMACY

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