How to Reduce Claim Denials and Get Paid Faster: A Pharmacist’s Survival Guide
You did everything right. You identified a clinical gap, you performed the service—whether it was a point-of-care test, a vaccine administration, or a complex MTM intervention—and you submitted the bill. Then, silence. Or worse, a letter in the mail or a code on your screen saying: health insurance claim denied. For pharmacy owners transitioning from […]
Adding Chronic Care Management (CCM) as a Pharmacy Service: A How-To Guide
You see them every month. The patients with diabetes and hypertension. The ones juggling five different prescriptions from three different specialists. They are the regulars at your counter, and frankly, you are already managing their care. You’re syncing their meds. You’re answering their questions about side effects. You’re calling their doctors to fix interactions. In […]
“I Got a Bill!” How to Handle Patient EOB Confusion When Billing Medical Plans as a Pharmacist
I hear from concerned pharmacists a lot on this topic, and I am hoping this blog post will help you and your concerned customers understand it better. You just successfully launched a new clinical service at your pharmacy—perhaps a comprehensive medication management session, a point-of-care test for flu or strep, or a travel health consultation. […]
A Pharmacist’s Guide to Billing for MTM Services: Common Pitfalls and How to Avoid Them
You spend 20 minutes with a patient, reviewing their “shoebox” of medications. You catch a duplicate therapy, you fix an adherence issue, and you explain exactly why they need to take their statin at night. The patient leaves happy and healthier. But when you look at the bottom line for that interaction, the revenue is […]
RxBB Achieves SOC 2 Type 1 Certification: Setting a New Standard for Pharmacy Data Security
In the pharmacy business, trust is everything. Your patients trust you with their health, and you trust your partners with something equally sensitive: your data. As pharmacy owners, we live in a world of strict regulations. We worry about HIPAA, we worry about PBM audits, and we worry about the ever-growing threat of cyberattacks. When […]
A Pharmacist’s Guide to Credentialing: How to Finally Bill as a Provider
As a pharmacist and pharmacy owner, you are one of the most trusted healthcare experts in your community. You perform clinical interventions, manage chronic diseases, and provide life-saving advice every single day. And you do almost all of it for free. I’ve been there. I remember the deep frustration of knowing I could solve a […]
Pharmacy Revenue Beyond Prescriptions: Services That Pay
It’s the question that keeps pharmacy owners up at night: “How do I stop losing money?” As a pharmacist and former owner, I know that feeling in the pit of my stomach. You look at the P&L sheet, and the math just doesn’t work. DIR fees are out of control, dispensing margins are thinner than […]
How to Launch MTM in Your Pharmacy: A 5-Step Guide for Owners
As a pharmacy owner, you’re on the front lines. You see the patients with multiple chronic conditions, the “shopping bags” full of prescriptions from different doctors, and the genuine confusion in their eyes. You have the clinical knowledge to intervene, optimize their therapy, and prevent costly hospital visits. But for decades, our system has only […]
Beyond the Counter: A Pharmacist’s Guide to Launching New Revenue Streams
As a pharmacy owner, you’re doing more work for less pay. It’s a story I know all too well. I remember standing in my own pharmacy, looking at the reimbursement statement, and feeling that all-too-familiar frustration. DIR fees, PBM clawbacks, and razor-thin dispensing margins… it felt like the system was built for us to fail. […]
