
2023 Together - PH347 - Pharmacy-Led Revenue Cycle Program: Optimizing Medical Drug Reimbursement Capture
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.
Target Audience
- Healthcare Quality Professionals
- Nurses
- Pharmacists
- Pharmacy Technicians
- Physicians
- Other Healthcare Professionals
Learning Objectives
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.

Credit Types

Interprofessional Continuing Education (IPCE)
This activity was planned by, and for, the healthcare team, and learners will receive .50 Interprofessional Continuing Education (IPCE) credits for learning and change.
Available Credit
- 0.50 ACPE Pharmacist
- 0.50 ACPE Pharmacy Technician
- 0.50 AMA PRA Category 1 Credit™
- 0.50 ANCC
- 0.50 CPHQ – Certified Professional Healthcare Quality
- 0.50 General CE - Attendance
- 0.50 Interprofessional Continuing Education (IPCE)