Third-party reimbursement for clinical pharmacy services: philosophy and practice.
A step-by-step approach is outlined for obtaining third-party reimbursement for clinical pharmacy services separate from dispensing fees. The program is based on a patient-care philosophy rather than a cost-conscious philosophy. The steps in implementation of the program were: (1) a total commitment to the patient's health, (2) identification of patient needs that require clinical pharmacy expertise, (3) development of a patient training program, (4) presentation of a written proposal to the hospital administration, (5) presentation of the proposal to third-party agencies, (6) initiation of charges for the services, and (7) preparation of reports on the progress of the program. Third-party reimbursement covers pharmacist instruction of home therapy patients receiving antihemophilic factor, cytarabine, parenteral nutrition, calcitonin-salmon and injectable analgesics. Financial data based on one year's experience with the program show that savings far outweight the charges.
D054598:Blue Cross Blue Shield Insurance Plans; D005252:Fees, Pharmaceutical; D007356:Insurance, Pharmaceutical Services; D009820:Ohio; D010348:Patient Care Team; D010605:Pharmacy Administration; D010607:Pharmacy Service, Hospital