A Guide for Pharmacists to Transform Patient Touchpoints into Billable Encounters

In the evolving landscape of healthcare, community pharmacies are uniquely positioned to enhance patient care by integrating clinical services into routine operations. By transforming everyday patient touchpoints into billable encounters, pharmacies can improve health outcomes and secure additional revenue streams. This comprehensive guide provides a roadmap for pharmacies aiming to make this pivotal transition to billing for clinical services.

The Need for Clinical Services in Community Pharmacies

Traditionally, pharmacies have focused on dispensing medications and offering consultations. However, the ever-increasing complexity of patient needs and a shift towards accessible patient care has called for pharmacists to expand their scope of practice. Pharmacists provide essential services within their communities that go beyond dispensing medications. By incorporating clinical services, pharmacists can: :

• Address Care Gaps: Many patients see their community pharmacists more than they do other healthcare providers. This uniquely positions pharmacists to provide services such as medication therapy management (MTM) and health screenings which can lead to addressing gaps in care that can improve the control of chronic disease states..
• Enhance Accessibility: Pharmacists are often more accessible than other healthcare providers, especially in underserved areas. Nine out of ten individuals in the United States are estimated to live within a five-mile radius of a pharmacy, making it a convenient setting for accessible healthcare services. Providing pharmacist-administered vaccinations and other clinical services increases patient access to essential healthcare.
• Strengthen Continuity of Care: By engaging in patient centered care, pharmacists have become an integral component of the healthcare continuum. The incorporation of clinical services into a pharmacy’s practice allows the pharmacist to collaborate with other providers to deliver comprehensive and coordinated patient care.

“Integrating clinical services into pharmacy practice is not just an opportunity; it’s a responsibility to meet the evolving needs of our patients.”

Examples of Clinical Encounters

Integrating clinical services into pharmacy practice involves offering a variety of interventions that are focused on patient-centered care, including:

• Medication Therapy Management (MTM): This service involves comprehensive reviews of a patient’s medications by a pharmacist to optimize therapeutic outcomes and minimize the chances of adverse drug events. Through MTM pharmacists provide in-depth medication education, consultation, and guidance to patients. They collaborate with the patient, their physicians, and other healthcare providers to help them achieve their treatment goals. .
• Vaccinations: Administering vaccines , such as influenza, shingles, and COVID-19, not only prevents disease but also positions the pharmacy as a convenient destination for preventive care. In the past several years, particularly highlighted during the COVID-19 pandemic, pharmacies offering vaccine administration has become a standard expectation in many communities.
• Health Screenings: Conducting screenings such as blood pressure testing, cholesterol levels, and blood glucose can help with early disease detection. These pharmacy screenings can lead to timely interventions and referrals to other healthcare providers.

Steps to Transition Patient Visits into Clinical Interactions

To effectively transform routine patient visits into billable clinical encounters, pharmacies should consider the following steps:

• Assess Current Capabilities: Evaluate existing resources, including staff expertise, space, and equipment, to determine readiness for offering clinical services. Identify areas that require enhancement to support new services.
• Train and Credential Staff: Ensure pharmacists and support staff receive appropriate training and obtain the necessary credentials to provide and bill for clinical services. This may involve pursuing state or federal mandated certifications in areas like immunization delivery or chronic disease management.
• Implement Workflow Changes: Redesign pharmacy workflows to seamlessly incorporate clinical services while minimizing disruption to dispensing activities. For example, offer appointments where specific times are allocated for MTM visits, and conduct them in private areas to accommodate for patient privacy and avoid distractions. Leverage Technology: Utilize electronic health records (EHRs) and billing software to document services accurately and submit medical claims efficiently. Familiarize yourself with appropriate billing codes to help prevent claim errors and ensure proper reimbursement from the medical plan.
• Engage Patients: Educate patients about the availability and benefits of clinical services, encouraging them to participate during their regular visits to the pharmacy. Use signage, brochures, and direct conversations to inform patients about services like health screenings and MTM.

Benefits for Patients and Pharmacies

Offering clinical services yields significant benefits for both patients and pharmacies:

For Patients:

• Improved Access to Care: Patients can receive essential health services conveniently at their local pharmacy, reducing barriers to care.
• Enhanced Health Outcomes: Services like MTM and health screenings facilitate better management of chronic conditions and early detection of potential health issues.
• Personalized Care: Pharmacists can provide individualized attention, tailoring interventions to each patient’s unique needs.

For Pharmacies:

• Diversified Revenue Streams: By transforming patient interactions into billable encounters, pharmacies can access new sources of revenue.
• Strengthened Patient Relationships: Offering clinical services fosters trust and loyalty, encouraging patients to view the pharmacy as a comprehensive healthcare resource.
• Professional Development: Pharmacists can expand their roles, increasing job satisfaction and professional fulfillment.

“By embracing clinical services, pharmacies can transform their role from medication dispensers to essential healthcare providers.” By integrating clinical care into the pharmacy, pharmacists can expand their role beyond dispensing medications to delivering essential healthcare services. “

Success Stories and Future Opportunities

Many pharmacies have successfully integrated clinical services, leading to notable outcomes. For instance, a pharmacy in Texas partnered with DocStation to implement a medical billing solution that automatically identified billable encounters.

In their first month, they earned over $19,000 in net new revenue, with projections exceeding $100,000 in the first year. This success underscores the potential for pharmacies to enhance both patient care and financial performance through clinical services.

Looking ahead, pharmacies can explore additional opportunities such as:

• Chronic Disease Management Programs: Offering specialized services for conditions like diabetes and hypertension can improve patient outcomes and provide additional reimbursement opportunities for pharmacists.
• Telehealth Consultations: Providing virtual consultations expands reach and convenience, allowing pharmacists to manage medication therapy and provide counseling remotely.
• Collaborative Practice Agreements: Partnering with physicians to manage patient therapies under agreed protocols can enhance care coordination and allow for expanded clinical services.

Embracing the Future of Pharmacy Practice

By transforming patient touchpoints into billable clinical encounters, pharmacists can play a pivotal role in advancing healthcare delivery. This approach meets the evolving needs of patients and also positions pharmacies for sustainable growth in a dynamic healthcare environment. Embracing clinical services enables pharmacists to improve patient outcomes, enhance professional satisfaction, and secure new revenue streams.

The healthcare industry continues to shift toward a model that prioritizes patient-focused care that is pharmacist-led. If your pharmacy has not yet integrated clinical services, now is the time to start. By implementing community pharmacy best practices, leveraging technology, and training your team, you can enhance patient care while increasing revenue through medical billing for clinical encounters in pharmacy.

Get Started Today

Assess your current workflow, educate your patients about available services, and optimize your pharmacy workflow for clinical services. With the right strategies, your pharmacy can become a leader in expanding pharmacy clinical roles, providing exceptional care, and securing long-term financial sustainability.

Are you ready to transform your pharmacy? Take the first step with DocStation today!