2023 Together - PH347 - Pharmacy-Led Revenue Cycle Program: Optimizing Medical Drug Reimbursement Capture - On Demand
With payor policies getting stricter and new-to-market drug costs on the rise, hospital infusion centers need to be seeking ways to optimize medical drug reimbursement capture. In this presentation, you will learn how to justify and implement pharmacy staff dedicated to revenue cycle roles in order to reduce provider workload and claim denial write-offs. The session will cover how to utilize pharmacists for systemwide peer-to-peers, proactively manage payor-preferred products, overcome site-of-care and pharmacy benefit manager (PBM) restrictions, optimize use of free drug programs, and closely monitor claim denials.
- Pharmacy Technicians
- Other Healthcare Professionals
Identify medical reimbursement gaps to justify dedicated pharmacy staff.
Explain how to integrate pharmacy staff into prior authorization and claim denial workflows for buy-and-bill medications.
Discuss how to optimize use of free drug programs in a large, multisite healthcare system.
Shannon Koch, PharmD, Pharmacy Revenue Cycle Manager, UChicago Medicine, Chicago, Ill.
Parin Shah, PharmD, Clinical Pharmacist – Specialty Infusions, UChicago Medicine, Chicago, Ill.
Interprofessional Continuing Education (IPCE)
This activity was planned by, and for, the healthcare team, and learners will receive 0.50 Interprofessional Continuing Education (IPCE) credits for learning and change.
Vizient, Inc. designates this enduring material for a maximum of 0.50 ANCC contacts hours.
Vizient, Inc. designates this enduring material for a maximum of 0.50 contact hours for Pharmacists.
Universal Activity Number: JA0006103-0000-23-192-H04-P
Pharmacy Technicians (CPE)
Vizient, Inc. designates this enduring material for a maximum of 0.50 contact hours for pharmacy technicians.
Universal Activity Number: JA0006103-0000-23-192-H04-T
Vizient, Inc. designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Other Healthcare Professionals (General CE Credit)
Vizient, Inc. will award a maximum of 0.50 contact hours to all other healthcare professionals who successfully complete the activity. These individuals will receive a Certificate of Participation indicating the maximum credits available.
Many state licensing boards and credentialing bodies accept certificates of participation from accredited CE activities to meet CE requirements for license renewals and re-certification. It is the responsibility of the participant to contact their state licensing board and/or certifying body for verification on credit eligibility reciprocity.
- 0.50 ACPE Pharmacist
- 0.50 ACPE Pharmacy Technician
- 0.50 AMA PRA Category 1 Credit™
- 0.50 ANCC
- 0.50 General CE – Attendance
- 0.50 Interprofessional Continuing Education (IPCE)