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Friday, April 17, 2015

Prescription Philling A la Carte

A Conversation with myself...
Me, Myself, and I: Welcome to Professional Label Slappers Anonymous. What brings you here today?
CP: I believe that we need to change the way we get reimbursed. We need to change the way we charge for prescriptions.
MMI: Just how would you accomplish this?
CP: We need to set up a menu. Something like a fast food's dollar menu.
MMI: Okay…Curious to see where this goes. Explain.
CP: There will be two sides to the board: FAST and ACCURATE.
On the FAST side, we will offer the following options:
1. selection of A medication, not necessarily the one prescribed for you.
2. professionally applied (read: slapped) label.
3. immediate checkout where you will pay AWP Plus $250.00
4. one signature to receive your prescription (which absolves the pharmacy of any liability).
MMI: Why so much?
CP: Convenience charge. Plus it pays for the lawyers.
MMI: Okay. What does the ACCURATE side get me?
CP: It's not what you think. For those that still want something quick and easy, we offer similar pricing. We still charge AWP PLUS $250.00.
MMI: How can you justify that?
CP: Simple. You ask for a prescription where all I do is "slap a label on it" or "dump pills in a little bottle". I can do that quite easily. Hence the reason we offer option #1-Fast. BUT…if you want me to put the correct information on the label, like your name, correct medication, strength, quantity, directions, refills, prescriber, etc. then that will cost you. If you wish me to check for interactions, make sure your prescriber isn't trying to kill you with poor penmanship or computer skills, or to check your allergies for you, then it will cost you.
MMI: I thought this was going to be less expensive. Why do you keep adding charges?
CP: Because the final step on the ACCURATE side is Billing Your Insurance. Once we bill your insurance, you will have a more acceptable, possibly, copay.
MMI: I see.
CP: Now all I have to do is bring this to everyone and let the (m)asses see it.
MMI: Insurances won't go for that.
CP: But they should. Imagine billing everything a la carte. For every part of the process, we are allowed to bill. Like prescribers and hospitals where every person that touches a patient gets to bill the insurance, there would be billing codes for each part of the prescription. Bottle, label, directions, DUR checks, tech time for data entry, tech time for filling, pharmacist verification--all billable.
MMI: You know they'd set limits, right?
CP: Yep. To the $10 minimum cost to fill a prescription with no drug in it, MINUS 20%, PLUS a $0.25 dispensing fee.
MMI: If you're lucky.

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