5 Innovative LTC Pharmacy Solutions from Order Entry to EOM Processing

If you are currently providing Long-Term Care (LTC) Pharmacy services or are planning to expand into the arena, you are not alone. LTC pharmacies are positioning to absorb the tremendous growth projected over the next decade as more and more of the first baby boomers choose long-term care facilities for their housing needs. This demographic is expected to double over the next 40 years, with nearly one-quarter of Americans being over 65.

With assisted living facilities and similar alternative housing communities springing up everywhere, the growing demand provides LTC pharmacies an opportunity to take a more significant role in managing the healthcare needs of patients, especially in light of the COVID-19 pandemic. Keeping pace with the industry during a public health emergency means ensuring that you are operationally sound and technologically secure. This lets facilities know they can rely on your services regardless of the environment.

5 Benefits of Alternative LTC Pharmacy Solutions

Once you can ensure high-volume prescription processing done accurately within the prescribed policies, procedures, and detailed regulations, you will then be positioned to acquire additional facilities. But how can you absorb these large blocks of patients efficiently with precision and accuracy? Consider a third-party team partner who can collaborate with you on the initial acquisition as well as the ongoing day-to-day business.

Here are five ways that a third-party partner can improve your overall operations:

  1. Order Entry — A third-party team can access arriving orders and enter them into your pharmacy system using the prescribed rules and protocols. They would be experts at pharmacy operations, understanding your unique Run-Times, Cut-Offs, and overall priorities.

  2. Admissions and Daily Census — By using a third-party team, the admissions process would be streamlined with patient files being set-up automatically, including demographic information, allergies, diagnoses, guarantor, and payment plans. Additionally, eligibility searches can be done to ensure all plans are located and added.

    Partners would also review daily census documents ensuring updated admissions, discharges, hospital leaves, bed holds, room changes, and coverage changes are all reported accurately.

  3. Prescription Refills — Rejected claims, early refills, duplicate documents, and cycle meds would be handled appropriately 24/7 and ensuring they’re sent on the earliest runs.

  4. Pharmacy Billing — In addition to maintaining prior authorizations for medications, your third-party partner would manage daily volumes of work, including intake registration, insurance eligibility, census maintenance, claims processing, payment posting, and Medicaid pending status.

    Also, denied claims and A/R could be optimized to ensure the maximum reimbursement is hitting your bottom-line.

  5. End-of-Month (EOM) Processing — EOM processing can be an arduous and burdensome effort. With a third-party partner, census reports can be reviewed and corrected. All monthly claims can be reviewed to ensure correct billing, and EOM reports can be compiled and distributed as necessary.

New Facility On-Boarding

In addition to daily operational support, whole facility onboarding represents a logistical nightmare, especially with the current coronavirus challenges. Using safe, off-site support, your operational hurdle can be conquered using third-party technology solutions for electronic data conversion. This proactive approach seamlessly dovetails with your pharmacy management software allowing your new clients to continue to care for their patients without the added stress of manual conversion.

You can be assured to meet your “go-live” date with a 100% high-quality patient account set-up for both medication, and ancillary orders. Your new clients will appreciate the fluid transition and error-free execution.

As you plan for the future and consider the nuts and bolts of data conversion and daily operations for new LTC facilities, an experienced and knowledgeable third-party partner can make the process seamless and efficient. Right now, long-term care and other alternative living facilities continue to weather the COVID-19 storm; offering safe and knowledgeable transition services goes a long way in building a trusting relationship.

Contact Infinx to learn more about LTC pharmacy transition solutions available today.

About the Author

Infinx
Infinx Healthcare provides innovative and scalable payment lifecycle solutions for healthcare practices. Combining an intelligent, cloud-based platform driven by AI with our trained and certified coding and billing specialists, we help clients realize revenue, enabling them to shift focus from administrative details to billable patient care.

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