Billing
26 Articles
Medical Billing for Vaccines: 132% More Revenue Per Shot
With flu season approaching and prescription margins continuing to shrink, independent and regional pharmacies are facing unprecedented pressure to find new revenue streams. DocStation’s innovative pharmacy software has just launched a revolutionary vaccine billing solution that could transform how pharmacies approach medical billing—and early results are already exceeding expectations.
The SHOT Method Webinar Recap: Capturing Overlooked Vaccine Revenue
Webinar Date: May 20, 2025 Presented by: Dr. Angelina Tucker, PharmD, BCGP, CDCES & Rachael Matz, Head of Clinical Solutions, DocStation
Fixing Pharmacy Vaccine Billing: How to Streamline Claims, Verify Coverage, and Improve Reimbursement
Why Outdated Billing Systems Are Holding Pharmacies Back—and What You Can Do to Maximize Revenue and Simplify Immunization Services
Credentialing Success: How Pharmacists Can Streamline the Insurance Verification Process
Credentialing is an essential part of the healthcare system, allowing providers, including pharmacists, to be recognized as eligible participants for reimbursement from health insurance plans. Pharmacists’ involvement in patient care, especially in medication therapy management (MTM) and chronic disease management, has grown significantly in recent years. As such, understanding the provider credentialing process is critical for ensuring reimbursement, access to patients, and continued professional growth. In this article, we will delve into what pharmacist provider credentialing is, why it’s essential, and how it varies depending on the type of payer, including Medicare and commercial insurances. Additionally, we will explore the difference between credentialing and contracting, as well as the role of third-party services in simplifying the process.
Demystifying Pharmacy Revenue Cycle Management: From a 20-Year Revenue Cycle Nerd
After spending two decades knee-deep in healthcare revenue cycles (yes, I proudly call myself a revenue cycle nerd!), I’ve learned that the difference between a thriving pharmacy clinic and one struggling to keep its doors open often comes down to one thing: how well they manage their revenue cycle. Whether I’m taking a break from hiking with my family or stepping away from playtime with my five grandchildren, I’m often reflecting on how to make RCM more accessible to those just starting in this field.
DocStation AI Payer Prediction: Automating Medical Claim Submissions with 90% Accuracy
Healthcare billing can be a complex maze of decisions and verifications that consume valuable time better spent on patient care. The DocStation AI™ Payer Prediction Model is transforming this landscape by streamlining the medical claim submission process with remarkable accuracy and efficiency.
Transform Your Pharmacy Revenue with DME Billing: A Success Story
*Note: This guide uses the fictional story of Mae Whelan and Whelan’s Pharmacy to illustrate the real opportunities and challenges in DME billing. While Mae’s story is fictional, it represents the actual experiences of many independent pharmacies implementing DME programs.*
![Webinar Recap] Pharmacy Revenue Mastery: Proven Billing Strategies from 2024 Top-Performing Pharmacies](https://cdn.sanity.io/images/076lcf0r/production/f82b95a4fe7b4c8d2e2c545da52efd80ad8bcf0b-1408x768.png?rect=128,0,1152,768&w=600&h=400)
Webinar Recap] Pharmacy Revenue Mastery: Proven Billing Strategies from 2024 Top-Performing Pharmacies
Did you miss our free webinar, “Driving Revenue Through Immunizations?” No worries! You can now watch the recording on YouTube or reference the PDF of the presentation here.
Simplifying Medicare: The Distinction Between Medicare’s Offerings for Medications and Pharmaceutical Care
Few medical professionals wear more hats than a pharmacist.
Medicare Part C vs Part D: A Pharmacist’s Guide to Helping Patients Navigate Coverage Options
Navigating the nuances of Medicare can be a challenge for anyone in the medical profession.
Webinar Recap: Maximizing Flu Shot Revenue with DocStation and ReNue Apothecary
Did you miss our free webinar, “Driving Revenue Through Immunizations?” No worries! You can now watch the recording on YouTube or reference the PDF below.
C vs D? How Pharmacists Can Optimize Medicare Part C vs D for Their Patients and Profits
Twenty years after Harry Truman spoke these words about the necessity of national healthcare, President Lyndon Johnson signed into law Medicare legislation, a historic moment intended to transform American healthcare for the better, forever.
Medicare Made Easy: A Breakdown of Medicare Part A vs B vs C vs D for Pharmacists
In the medical field, there are few sayings that are more true than this one.
From Frustration to Freedom: 3 Ways Pharmacy Management Software Can Revolutionize Your Medicare Part C and D Billing
It’s a wild world out there for pharmacists these days. From ever-changing formulary lists and frustrated patients, to staying updated with the latest regulations, keeping your head above water can often feel like a constant battle.
Q&A with DocStation CEO: How are pharmacies integrating automations into their workflows?
At the forefront of healthcare innovation, the integration of Artificial Intelligence (AI) and automation in pharmacy operations is still just budding, yet it’s poised to redefine the way we manage and deliver care. As someone deeply embedded in the tech side of healthcare, I see a world of opportunity—but it’s crucial that we navigate it wisely.
Key Differences Between HCPCS vs CPT for Pharmacies
Pharmacies are the unsung heroes in healthcare, right? They provide essential services for the community, from safely filling prescriptions to giving health advice. To get the billing right for these services, pharmacists need to be on the ball with their accuracy. That’s where medical billing codes come into play, and two types you’ll see a lot are HCPCS and CPT codes.
Pharmacy Quality Improvement Initiatives To Implement in 2024
Medication errors, adverse drug reactions, and non-adherence all pose significant threats to patient well-being. So, quality improvement initiatives (QI) represent a strategic and necessary commitment to advancing the safety of healthcare services.
DocStation: The Best Mobile MediClaim Software Alternative
Pharmacy billing processes can be complicated and time-consuming thanks to complex billing codes, manual entry errors, authorization issues, adjudication delays, and more. These factors cause headaches that steal valuable time from patient care. That’s why savvy pharmacies invest in software to streamline the process.
Streamlining Flu Season Billing with AI Technology: Introducing DocStation’s Auto-Billing
Flu season is upon us, and for pharmacists, this means a surge in vaccine administrations and billing tasks. Manual billing for vaccine claims can be a cumbersome and time-consuming process, leaving pharmacists with little time for other crucial activities. But what if there was a smarter way to manage your pharmacy’s billing process? Enter DocStation’s Auto-Billing technology, a revolutionary solution that harnesses the power of AI to streamline billing during flu season and beyond.
Introducing BIN Billing
In the ever-evolving landscape of healthcare, efficiency and precision are paramount. Pharmacists, as frontline healthcare providers, are constantly seeking ways to streamline their processes and enhance patient care. Enter DocStation’s BIN billing – the latest game-changing feature that allows pharmacies to submit claims directly from their dispensing system for automated medical billing. But what exactly is BIN billing, and why should it matter to you? Let’s dive into the details.
The Future of AI: Pharmacy Applications & Workflows
In today’s increasingly digital world, artificial intelligence (AI) has emerged as a transformative force, revolutionizing industries and reshaping the way we work.
The DIR Double Whammy: What Pharmacies Need to Know to Stay Afloat
Pharmacy benefit managers (PBMs) are the malevolent puppeteers in the complex ecosystem of the pharmacy world. These entities, known for their opaque pricing models and damaging reimbursement policies, have mercilessly crushed pharmacies with their practices, leading to such abysmal reimbursement rates that many pharmacies have either had to close their doors or seek revenue outside of dispensing revenue tied to PBMs.
Top Benefits and Challenges in Medication Therapy Management
Medication therapy management (MTM) is a program that can help ensure patients receive the most appropriate medications and allows pharmacists to efficiently monitor a patient’s progress and optimize health outcomes. Learn more about how MTM can improve patient outcomes while making medication management easier for providers.
The Future of Monkeypox and How To Prepare
Despite the fall in reported cases of Monkeypox (now transitioning to being called Mpox1) since the peak in August 2022, people all over the country have found themselves asking: “what is this disease and is there a monkeypox vaccine?” Unfortunately, in-depth patient and community member knowledge and understanding of monkeypox and smallpox vaccines is limited. So, pharmacists, drug manufacturers, and other providers are often the ones left filling in the gaps.
Pharmacy CPT Codes Explained
Whether you’re a pharmacy owner or a practitioner, there’s no doubt that operating a pharmacy can be challenging in today’s market. Aside from declining reimbursement, PBM shenanigans, and controlling costs, ensuring a steady cash flow can be difficult. If your pharmacy bills to patients’ medical benefit, a big part of that difficulty lies in billing and all the processes that follow. As with many industries, getting paid or reimbursed for services and the steps to follow up can take up valuable time and resources.
Medical Benefit vs. Pharmacy Benefit: An In-Depth Look
Almost fifty-five years ago in the world of health insurance, a split occurred between the medical benefit and pharmacy benefit. Claims processing for pharmaceuticals had grown to a volume that required a unique solution for insurers. New companies and subsidiaries were created to meet this growing demand, and unique pharmacy billing practices arose from them. US pharmaceutical sales reached approximately $555 Billion in 2021, the vast majority of which were processed through insurance governed by the pharmacy benefit instead of the medical benefit. As states continue to pass provider status legislation, the majority of covered clinical services would be covered by the medical benefit.