Point of Care Programs Jeff Azevedo

Slides:



Advertisements
Similar presentations
Pharmacy Benefit Managers (PBMs)
Advertisements

Introducing the Abacus Pharmacy Plus Software. Security Multiple security levels can be activated or none at all. You can define all or specific functions.
Sales Rep Process Training
SHELLY GUFFEY MAKING THE MOST OF YOUR REVENUE CYCLE MANAGEMENT TECHNOLOGY
Informatics And The New Healthcare System Information Technology Will Provide the Platform for Quality Improvement in Healthcare for the 21 st Century.
This presentation contains confidential and proprietary information of Caremark and cannot be reproduced, distributed or printed without written permission.
1 EHR SERVICES OVERVIEW A PRIMER ON MEDICAL DATA ENTRY SERVICE USAGE.
Module 10: Pharmacy. 2 Module Objectives After this module, you should be able to: Describe the TRICARE pharmacy benefit List who is eligible for TRICARE.
HealthTranz Payment Solutions Total Payment Solutions for Healthcare Practices.
Module 10: Pharmacy. Module Objectives After this module, you should be able to: Describe the TRICARE pharmacy benefit Explain features of the various.
STAT Transcriptions May STAT Transcriptions Profile We are Healthcare BPO with Transcription and Coding services. Who we are What Are Our Capabilities.
© 2005 National Mental Health Association The Medicare Drug Benefit: What Is It and What Does it Mean for Mental Health?
Workers Comp Help Desk. The Workers Comp Help Desk is designed to provide the highest level of convenience and support for Industrial Carrier Professionals.
Revenue Cycle Outsourcing September 7, 2015September 7, 2015September 7,
Maybe you’ve heard someone talk about the “new” Group Health
Module 10: Pharmacy. Module Objectives After this module, you should be able to: Describe the TRICARE pharmacy benefit Explain features of the various.
Highest quality medications… Lowest possible cost.
NDCHealth Confidential Electronic Prescribing Cutting the Costs of Paper.
Member Mail Order Helpful Hints, Reminders and Tools.
Presentation Software as a Service Applications Software-as-a-Service Partner Enablement Program Enabling ‘Software as a Service’
K NOWLEDGE S ERVICE E XPERIENCE Integrated Clinical Solutions.
Module 10: Pharmacy. 2 Module Objectives After this module, you should be able to: Describe the TRICARE pharmacy benefit List who is eligible for TRICARE.
FINANCIAL ISSUES CHAPTER 14. CHAPTER OUTLINE Financial Issues Third-Party Programs – private health insurance – managed care programs – public health.
Powered by:. What is Physician’s Dispensing? Physician’s Dispensing is when a practice has the ability to fulfill patient prescriptions at the point of.
1 Overview of TMOP and TRRx Pharmacy Programs. 2 Presentation Outline Express Scripts Overview TRICARE Mail Order Pharmacy Program Review TRICARE Retail.
“Best in Class” Revenue Cycle Solutions for Healthcare Presented by RevCure Consulting.
Pharmaceutical Company – Catamaran
Pharmacy Benefit Management (PBM) 101
Financial Issues Chapter 14. Financial Issues Financial issues have a substantial influence on health care and pharmacy practice. In 1985 the average.
E-Prescriptions Krishi. E-Prescriptions Overview One major contributor to PAEs is patient medication errors, and the implementation of e-prescription.
How To Select a Third Party Administrator CapabilitiesCost Service Model Jerry L. Ripperger, Director – Business Development Registered Representative,
California Department of Public Health, Office of AIDS, AIDS Drugs Assistance Program (CDPH/OA/ADAP) Pharmacy Program Provider Training.
Group Name Employer ID: CHO Name Here Title Here.
Group Name Employer ID: CHO Name Here Title Here.
Effective Prescription Safety Net Programs in Action
The Pharmacy Technician 4E
University of Texas System 2017 UT SELECT Part D Overview
What is the Best Way to Select an EHR
Inventory Management Chapter 13.
ALAMO FAMILY HEALTH TEAM 1.
Why pricing transparency?
Group Name Employer ID: CHO Name Here Title Here.
Group Name Employer ID: CHO Name Here Title Here.
Health Advocate Overview
The State of New Mexico Group Benefits Plan Plan Year: January–December 2018 Prescription Drug Program.
Presentation For.
Financial Analysis Of Electronic Health Records (EHR’s)
Medication Dispensing Program
Harbortouch’s Association Referral Program
The Basics of Pharmacy Benefit Management (PBM)
How to Strengthen your Bottom Line with a Quality Partner!
VAR Partner Program Value Added Reseller
Group Name Employer ID: CHO Name Here Title Here.
Group Name Employer ID: CHO Name Here Title Here.
Working hard to provide reliable, affordable coverage
Group Name Employer ID: CHO Name Here Title Here.
Billing and Financial Issues
MedImpact Direct™ March 12, 2015 Bill Barre
Group Name Employer ID: CHO Name Here Title Here.
Prescription Safety Net Programs in Action-Outcomes and the Future
Implementing Direct Payment for Clinical Pharmacy Services
Ametros Overview.
Delivering Accurate Patient Estimates
Company Overview.
Concierge Medicine IN PRIMARY CARE CONSTANTINE GEORGE, M.D.
Health Care Information Systems
TRS-ActiveCare Lifting your spirit SUMMER ENROLLMENT
Stability Management Software
Jeff Azevedo President & CEO
Competitive Advantages
Presentation transcript:

Point of Care Programs Jeff Azevedo Jeff@AdvancedRxMgt.com Presented By: Jeff Azevedo Jeff@AdvancedRxMgt.com 925.984.5049

Company Overview Wholesale Medications Pharmacy & Dispensing Systems Staffing Formulary Optimization Billing & Collections Headquarters: Northern California Size: Over 500 Practices in 18 States Programs: In Office Pharmacy Physician Dispensing Drug Testing & Confirmations POC Program Management Full Service Organization

Competitive Advantages Maximize Revenue Capture Revenue Streams That Have Traditionally Been Referred Outside of Practice With Minimal Overhead, Substantially Increase Your Practice’s Revenue Customer Benefits: Improve Patient Satisfaction Provide Secure & Comfortable Care Offer Most Convenient Care Available Understand Patient Needs Manage Patient Outcomes Manage Medication Protocols Many Patients Fail to Pick Up Rx 75% of Americans Report To Not Take Medications As Prescribed 30% of Americans Stop Taking Their Medicine Before It Runs Out Insurance Carrier Relationship Insurance Negotiation Team Works Collaboratively With Carriers Maximize Practice Reimbursement Ensure Positive Insurance Carrier Relationships & Maintain Referrals Turn Key Programs Medication and Staffing Costs Deducted From Future Reimbursements Practices Never Pay Us or Suppliers Directly All Hardware & Technology Included Advanced Rx Benefits: Leverage Multiple Suppliers Competitive Pricing Less Prone to Shortages Medication Market Intelligence Diversified Product Offering Additional R&D Resources

Point of Care Dispensing Stage 1 OTC Work Comp Dispensing Stage 2 Full-Formulary Work Comp Dispensing Stage 3 Full-Formulary Commercial, Medicare, & Work Comp Dispensary Stage 4 Point of Care Pharmacy

Stage 1 OTC Work Comp Dispensing No Minimum Volume Requirements No System Implementation Required Dispensing Performed Via Fax or Scan Workers Comp & Cash and Carry Only High Patient Favorability Substantial Reimbursement Revenue Very Low Overhead on Staff

Stage 2 Full-Formulary Work Comp Dispensing Minimum of 40 Scripts Per Month Online System Implementation All Systems, Processes and Training Provided Practice Chooses Medication Inventory Ongoing Formulary Optimization Effective Insurance Company Relationships Lowest Wholesale Prices for Medications

Stage 3 Full-Formulary Commercial, Medicare, & Work Comp Dispensary Minimum of 400 Scripts per Month Pharmacy Management System Implementation Requires Dedicated Dispensing Staff Complete Set Up Including: Processes Hardware Software Storage Training On-going Support

Stage 4 Point of Care Pharmacy Minimum 2,000 Scripts per Month Licensed Pharmacist in Charge Full Support for ALL Patient Types No Longer Classified as Physician Dispense Patients Benefit from Convenience & Cost Improve Patient Outcomes Enhanced Compliance Refill Support Program Includes Licensing Implementation Medications Storage Process Training Hardware

Prescription Routing Process Workflow Optimization Minimal Overhead to Practice Standard Prescriptions and/ or Electronic Prescribing Our data transfer service allows practices to operate efficiently with a hassle-free transition. E-Prescribe From Practice EMR Complete Dispense! Prescription sent in-house, rather than to outside pharmacy Label is printed In-House Dispensary/ Pharmacy Collect Any Missing Patient Info Patient demographic & insurance info automatically transfer

Electronic Adjudication Initiate Dispense Transaction Routed Through RelayHealth Carrier/PBM Response Commercial & Medicare Billing Immediate Feedback on Patient Benefits Pre-Authorization Insurance Reimbursement Amounts Co-Pays Brand Vs. Generic Acquisition Costs Net Margin All PBM Companies in Network Medicare Claims 2 Week Turnaround on Reimbursements

Value Added Services Provided Formulary Optimization Minor adjustments can drastically improve physician’s net reimbursement. Insurance Company / PBM Management Contracts, electronic adjudication, medication preferences. Direct Relationship to Practice Eliminating pharmacy call backs, faxes, emails, etc. Expert Billing Services Relationship management with insurance carriers ensures reimbursement.

Drug Testing & Confirmations 24 Hour Turnaround For Results Provide Dictated Reports to Physician Cutting-Edge LC/MS/MS Lab Technology Full Integrated with Our Dispensing Platform Urine & Swab Options Test Panel Groups: Antidepressants Narcotics / Opiates Anticonvulsants Sedatives Barbiturates Stimulants Benzodiazepines THC (Cannabinoids) Ensure Medication Protocol Compliance Reduce Practice Liability Earn Additional Revenue

Improve Patient Care Improve Patient Outcomes - Enhanced Compliance Full Refill Support Mail order option Convenience Cost Competitive Trusted Source Quicker Processing of Authorization Direct access to patient and insurance data.

Transparency & Accountability As Your Business Partner We Provide Monthly Reports Clear understanding of monthly activity with a detailed summary of all costs and billing activity for the month.  

Point of Care Services Partnership We Add Value to Your Practice! www.AdvancedRxMgt.com