Making pharmacy and business work together

Sustained financial growth is one of the top challenges for even the most successful organizations in the healthcare industry. Effective pharmacy programs can increase revenue by maximizing existing opportunities, creating new programs and services and reducing costs. Our team of experts is here to help maximize financial performance within your organization through our mastery of pharmacy operations, billing and reconciliation within retail and specialty pharmacy, medical and pharmacy benefit implications, and revenue cycle gaps within health systems. Our consultants bring a wide range of experience to the table to assist each of our clients in a way that best fits them and their financial goals. Our financial performance consulting services include:

  • Pharmacy revenue cycle review and gap assessments
  • Pharmacy pricing structure analysis and design
  • Charge master assessment and optimization
  • Billing, reimbursement and accounts receivable management, including:
    • Retail and specialty billing, reimbursement and A/R
    • Implementation of retail A/R solutions
    • Specialty pharmacy contracting
  • System-level P&T committee/formulary management analysis, design and implementation
  • Employee prescription plan development
  • Drug utilization and cost assessment
  • Central prior authorization and benefit investigation support, gap assessments and implementation
  • Medicare Part B enrollment and billing establishment
  • Major medical vs. pharmacy benefit support