The truth is that clinical care already eats up the substantial time and efforts of most specialty pharmacies. Your team may feel burned out when they handle specialty billing responsibilities along with administrating specialty drugs. That is why most specialty pharmacies outsource their billing to third-party RCM companies, allowing them to focus solely on clinical care. However, choosing the right billing company is challenging due to the many options available. To find the best specialty pharmacy billing company, it’s essential to ask key questions for proper evaluation. Following are the questions that you should ask to your outsourcing partner-

Critical questions to ask a specialty pharmacy company-

1) Do they have expertise in specialty pharmacy?

Specialty pharmacy billing requires unique knowledge and expertise as it is a unique practice. Ask the billing team if they have experience and knowledge in your domain. For example, ask them if they have a sound understanding about C-codes, J-code, etc.

2) What will it cost?

The cost is the central concern for every practice, but still, you need to consider the value that you are getting. Make sure you ask about the services offered by the billing company. The company should be able to meet and beat any price.

3) Can they provide references?

Ask if they can provide references from other specialty pharmacies. A reputable specialty pharmacy billing company should be able to provide you with a satisfactory number of referrals.

4) Do they recruit certified professionals?

A professional billing company always recruits certified and experienced billing experts. So, ask what kind of certificates their specialty pharmacy coding experts have.

5) Who owns the billing data?

You should be the owner of your billing data. If you need to change the billing company, you should be able to take the billing data with you.

6) Do they comply with HIPAA?

HIPAA requires every billing company to adhere to their regulations to protect Patient Health Information. Ask if the billing company strictly adheres to all the regulations set by HIPAA and other insurance companies. Also, do not forget to ask about their security protocols.

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7) What kind of contract do they offer?

You should always select a company that offers non-binding contracts. It means you have the flexibility to terminate the contract if you are satisfied with their services.

If you are looking forward to hiring a company that meets all the requirements mentioned above, partnering up with Sunknowledge can be a perfect decision. As one of the leading RCM companies, Sunknowledge has streamlined the billing practices for more than hundreds of specialty pharmacies across the nation.


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