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On-Line Billing for Custom Compounds: The Third-Party Payor

Author(s):  Heckman H Edward

Issue:  Nov/Dec 2000 - Compounding for Hormone Replacement Therapy
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Abstract:  Compounding pharmacists must be alert and prepared for the latent liability they create by transmitting compounded prescriptions claims on line at usual and customary prices. The author describes the latent liability of third-party billing, and alternatives (negotiating an exclusion or fee schedule or terminating your agreement). He concludes by advising compounding pharmacists to select the option that is best for their business and practice. Although none of the choices is clear or easy, devoting some thought to proper billing of compounds may result in more profit and avoidance of large audit repercussions.

Related Keywords: billing, collection, fee, insurance, on-line billing, PBM, pharmacy benefits manager, third-party

Related Categories: BUSINESS

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