Streamlining RCM for Pharmacies
Optimized Revenue Cycle Management Solutions for Pharmacies
Pharmacies play a critical role in the healthcare ecosystem, managing not only medication dispensing but also complex billing and insurance processes. At One Hive, we provide specialized Revenue Cycle Management (RCM) services tailored to the unique needs of pharmacies, ensuring that your financial operations run as smoothly as your healthcare services.
Core RCM Services
For Pharmacies
Efficient Prescription
Billing
Handling prescription billing can be complex. Our RCM solutions streamline the process, ensuring accurate claims submission and prompt reimbursements.
Insurance Verification and Coordination
A major challenge in pharmacy management is verifying insurance coverage. Our services automate this process, reducing delays and ensuring patients receive their medications promptly.
Regulatory
Compliance
Pharmacies must meet strict regulatory standards. Our team ensures compliance with all relevant regulations, minimizing the risk of audits and penalties.
Patient Billing and Collections
Handling prescription billing can be challenging with varying insurance policies and regulations. Our RCM solutions streamline the process, ensuring accurate claims submission and prompt reimbursements.
Inventory and Cost Management
Effective inventory management is key to a profitable pharmacy. Our RCM services include tools for tracking inventory costs and managing reimbursements, helping you maintain a healthy balance between stock levels and financial performance.
Data-Driven Decision Making
We provide pharmacies with advanced analytics and reporting tools that offer insights into sales trends, reimbursement rates, and financial performance, enabling you to make informed decisions that enhance profitability
Get Started
Partner with One Hive for Efficient Pharmacy RCM
Running a pharmacy requires balancing excellent patient care with effective financial management. Let us handle the intricacies of Revenue Cycle Management, so you can focus on what matters most—providing quality healthcare services to your customers.
Case Studies
Popular Use Cases
Medical Coding
(5.8K +)
Cardiology Case Study
Client: A large cardiology practice struggling with claim denials for complex cardiac procedures.
- Challenge: The practice was facing a high denial rate for procedures like cardiac catheterizations and echocardiograms due to coding errors and insufficient documentation.
- Solution: We implemented a tailored RCM solution focused on accurate coding (CPT and ICD-10) and pre-authorization workflows. Our team provided specialized training to ensure cardiologists and staff understood the importance of detailed documentation for these high-value procedures.
- Result: Denial rates dropped by 30%, and overall collections increased by 20% within six months.
Medical Billing
(5.8K +)
Oncology Case Study
Client: A multi-location oncology clinic experiencing slow reimbursements from payers.
- Challenge: The clinic’s complex chemotherapy billing, along with frequent coding errors, resulted in delayed payments and denials.
- Solution: We optimized their billing processes, ensuring accurate coding for drug administration, therapies, and supportive care. We also developed a system for monitoring claims and tracking prior authorizations to minimize delays.
- Result: Claims processing times were reduced by 40%, and their accounts receivable over 90 days decreased by 25%.
Transcription
(5.8K +)
Orthopedics Case Study
Client: An orthopedic group facing issues with high patient balances post-surgery.
- Challenge: Many patients were unaware of their out-of-pocket costs, leading to a high volume of unpaid bills after surgeries.
- Solution: We created a patient financial engagement plan that provided upfront cost estimates based on insurance benefits and out-of-pocket requirements. Our RCM team also implemented automated payment plans for patients.
- Result: The practice saw a 35% increase in patient collections and a 20% reduction in the time it took to receive payments from patients.
Medical Coding
(5.8K +)
Pediatrics Case Study
Client: A pediatric practice with a high rate of claim rejections due to coding inconsistencies.
- Challenge: The practice struggled with frequent rejections on well-child visits and immunizations, which affected their revenue stream.
- Solution: We worked with the pediatricians to ensure proper coding for preventive care and vaccinations, while also enhancing their billing software to identify errors before submission.
- Result: The claim rejection rate dropped by 45%, and the practice experienced a 15% increase in monthly revenue.
Medical Billing
(5.8K +)
Behavioral Health Case Study
Client: A behavioral health clinic dealing with denied mental health service claims.
- Challenge: The clinic faced constant challenges from payers regarding the medical necessity of services, which led to claim denials.
- Solution: Our team provided detailed training on the necessary documentation to establish medical necessity. We also revamped their claim appeals process and set up follow-up procedures for denied claims.
- Result: The clinic reduced their denial rate by 50% and increased collections by 18%.
Testimonial
What Our Clients Say
Our doctors’ testimonials showcase how OneHive’s RCM solutions have streamlined billing, improved cash flow, and enhanced patient care. Their feedback underscores our commitment to efficiency and exceptional support.
4.9 Rated
Partnering with OneHive Billing Solutions has been a game-changer for my practice. Their team handles everything from billing to denial management with incredible efficiency, allowing me to focus solely on my patients. My revenue has never been this consistent!
Dr. Sarah Mitchell
@Family Medicine
5.0 Rated
What sets OneHive Billing Solutions apart is their personalized approach and commitment to excellence. From the moment we signed on, they’ve been proactive in resolving billing issues, improving cash flow, and keeping us compliant. They’re a fantastic partner!
Dr. Angela Lee
@Dermatologist
4.9 Rated
I used to spend hours dealing with billing errors and insurance claims. Since we started working with OneHive Billing Solutions, I’ve seen a 30% improvement in collections, and my claims are getting paid faster than ever. Their expertise is unmatched.
Dr. James Carter
@Cardiologist
4.8 Rated
I’ve worked with other RCM companies in the past, but none have matched the level of service and results we’ve experienced with OneHive Billing Solutions. Their attention to detail and quick follow-up on denied claims have been essential in growing my practice’s revenue.
Dr. Michael Brown
@Neurologist
5.0 Rated
Before OneHive Billing Solutions, we struggled with delayed payments and high denial rates. Their streamlined process has transformed our revenue cycle, and I no longer worry about unpaid claims. They truly understand the needs of physicians.
Dr. William Harris
@Orthopedic Surgeon
4.9 Rated
The team at OneHive Billing Solutions is highly professional and knowledgeable. They’ve significantly reduced our claim rejection rates, and their reporting tools provide valuable insights into our financial health. I highly recommend their services to any medical practice!
Dr. Emily Rodriguez
@Pediatrician