Medical billing

Medical billing software

Have no idea where to start? Check out our 20 minute Introduction to Billing for Pharmacist Clinical Services hosted by Aaron and Amanda to learn what to look for and questions to ask when evaluating clinical support software.

DocStation
CPESN MBS partner! Founded by a KU residency trained pharmacist, DocStation has a full EHR complete with patient facing appointment manager and bidirectional patient communication tools. DocStation features no up-front costs with low monthly fees and a moderate percentage charge. Other features include an auto-billing option to identify and trigger billing for services as well as integration into PioneerRx and Liberty for real-time communication.

• DocStation recording
• Special offer from DocStation for KPhA members!!
• Contact: sales@docstation.co
  

EBS + Signetic
CPESN MBS Partner! Established company providing DME and medical billing through your existing pharmacy software. They have low upfront costs and low revenue percentage charge subject to a monthly minimum. They pride themselves on excellent customer service and have a team that can check a patient’s eligibility for the service before it’s provided. EBS has recently partnered with Signetic, a modular clinical platform that allows for patient appointments, clinical documentation, and medical billing.

• Contact: Mary Stoner

Scripted

CPESN MBS Partner! An All in one solution for clinical services, Scripted allows for built in protocols or custom clinical workflows. They can provide CPAs to pharmacies for an additional cost, have an appointment scheduling solution, and also provide marketing support to advertise your services to your community. They also have ScriptedAcademy to help you stay up to date on

TransactRx
CPESN MBS Partner! A cross-benefit clearinghouse, TransactRx is designed to let you bill for clinical services using your dispensing software. With no monthly fees and a low per claim fee, a recent purchase by RedSail Technologies has currently waived onboarding fees, decreasing the barrier to entry for medical billing. For pharmacies with a robust pharmacy system such as QS-1 or PioneerRx, this could be a great option.

• TransactRx recording
  
• Contact: Fabi Carmona

Workflow Services

CPESN MBS Partner! An integrated clinical platform, Workflow Services walks patients and pharmacies through the steps necessary to follow statewide protocols, then the automation engineering pulls data and generates a claim to submit to insurance. While they are currently limited to statewide test and treat protocols, they have freeform documentation and billing coming in 2025.

• Contact: Robert Merry

What is CPESN MBS?

CPESN Medical Billing Supports is a special purpose network that provides medical billing education and payer engagement assistance for participating CPESN Kansas pharmacies. CPESN MBS works at the state level to monitor claims and help pharmacies work with payers to ensure pharmacies are sending out appropriate claims and monitoring for high levels of rejections to address claims issues. You'll gain access to the full PharmFurther database and learn from a monthly Clinical PhOCUS webinar with Travis Wolff, plus have access to a Kansas-specific monthly medical billing check-in to address payer or platform problems. Contact CPESN Kansas to learn more!

Assure Care
AssureRx is a full service EHR, credentialing, and billing platform. Don't want to take the time to go through credentialing and enrollment? AssureRx can help! They have moderate up front costs and high monthly costs but offer 1 year of major discounts for CPESN sites. They offer documentation and billing support for clinical services and are guided by a pharmacist with many years of experience in the space.

• AssureCare recording
  
• Contact: Tara Pfund

Change Healthcare

A low cost solution, pharmacies can use Optum's MedRx to connect to a broad network of commercial and government payers directly from your pharmacy-management system to bill medical claims such as immunizations and DME. Plus, use advanced, front-end editing capabilities to help prevent denials and accelerate reimbursement.

EnlivenHealth

EnlivenHealth can provide multiple solutions to community pharmacies, from their clinical documentation tools to patient engagement solutions. Their Amplicare Clinical Solution combined with the MedBill option makes a powerful tool for pharmacies interested in performing many different clinical services. No onboarding but high monthly costs will benefit pharmacies ready to jump in with a fantastic interface. Several pricing levels exist and bolt-on options makes this customizable to your pharmacy's needs.

• EnlivenHealth webinar recording
  
• Make an appointment for a personalized demonstration and cost evaluation: EnlivenHealth

Office Ally
If you have an existing software that can create HCFA forms, you can submit claims for free using the OfficeAlly clearinghouse service. A simple enrollment process and no contracts makes Office Ally an option if your payers are already using their clearinghouse.

• https://cms.officeally.com/Pages/Products/Clearinghouse.aspx
  

OmniSYS

• https://www.omnisys.com/our-solutions/clinical-services/

RXNT
A cloud-based platform, RXNT offers both an EHR and billing solution, with several attractive included and add-on products. While the platform is built for and geared towards physicians, appointment reminder texts, patient invoice generators, and a great claims tracking system will work well for many pharmacies.

• Billing software demo
• Contact: Jim Mayes