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Pharmacists sometimes have hundreds of prescriptions to fill each day. In a fast-paced environment, sometimes good billing practices and operational habits can be overlooked, jeopardizing the health of your business. Here are the top 5 things you should do to make sure you receive optimum reimbursement from third-party payers.     

Some situations require a pharmacist to submit a claim that, under normal circumstances, would be rejected by the third-party payer.  For example, a patient is going on a vacation and requests a three-month supply of their medication.  To prevent rejection, this claim must be submitted with a Submission Clarification Code. In this article, we look at how submission clarification codes are used and offer some best practices that may help you ensure proper reimbursement. 
How can you quickly identify potential rejections for prior authorizations, non-formulary fills, quantity supply, and step therapy requirements? The Medicare Part D Transition Policy allows some patients access to prescription drugs within 30 days of their enrollment in a Medicare Part D plan. Pharmacies need to be efficient and proactive when managing these claims.
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