Pharmacy
billing is the most vital part of every healthcare organization,
where a medical service is translated into a billing claim and is
submitted to a healthcare insurance company for reimbursement.
It is a complex set of procedures which demands a lot of time by
skilled professionals. A patient’s medical record is maintained
throughout the treatment and after the patient provides the full
insurance details to the hospital, the pharmacy billing procedure
starts, also referred to as revenue cycle management.
Before
the pharmacy bill is submitted to an insurance company, the medical
treatments or services are allotted a certain alphanumeric code
according to a standardized system after which the insurance company
decides which part of the claims will and will not be paid. The whole
procedure of pharmacy billing is facilitated by a billing software,
called pharmacy billing software.
There
are a number of advantages which a pharmacy billing software offers,
which are as follows:
- Quick and easy entry of data without much repetition
- Reduces claim denials
- Tracks and analyzes financial performance
The
pharmacy billing software market can be categorized into two major
segments, which are as follows:
Electronic
health records (EHR) or electronic medical records (EMR) software:
It
is a systematic collection of medical treatment data of an individual
patient or a group of patients. The patient data includes
demographics, personal statistics such as age, weight, test results,
medical history etc.
Revenue
cycle management (RCM):
RCM
software ensures reimbursement and reimbursement compliance
effectively from start to finish. It provides better access
management, improved consumer self-service, streamlined billing
process, and an efficient monitoring of insurance companies.
The
main driving factors for the growth of pharmacy billing software
market are better management of patient’s clinical information and
patient’s accounting documentation, processing of insurance claims
for a faster reimbursement, and smooth functioning between the
healthcare organization and the insurance company (payer). Without
pharmacy billing, the hospitals would result in a chaotic environment
with disorganized patient information and lack of communication
amongst individuals.
Geographically,
North America holds a leading position in the pharmacy billing
software market followed by the European market. Major factors
responsible for the growth of this market in these regions are
maintenance of up-to-date and proactive medical service, elimination
of billing errors, and the growing need of individuals to access
faster reimbursement procedure from the concerned insurance company.
Asia-Pacific is one of the most developing regions globally and is
emerging out to be a lucrative region for the growth of pharmacy
billing software market. The prime factors which will drive the
growth of this market in Asia-Pacific regions are increasing need of
the population to maximize their insurance payments by proper
processing of the provider’s claims, growing demand of individuals
to receive the best patient care with regards to medical and pharmacy
services, efficient and effective business operations by the
healthcare provider, and better denials prevention and management.
Moreover, proper maintenance of track of bills and payments for the
right information to be recorded will also augment the growth of
pharmacy billing software market in the near future.
Some
of the major players operating in the pharmacy billing software
market are Healthpac Computer Systems, CareCloud Corporation, Kareo,
AllegianceMD, Accumedic Computer Systems, NextGen Healthcare
Information Systems, LLC, AthenaHealth, McKesson Corporation and many
others.
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