Advancing The Profession of Pharmacy

LESSON 12 in the Pharmapreneur Academy – Offering Cash-Based Consultant Pharmacy Services: Virtual and In-Person

by | Dec 17, 2018 | Consulting Pharmacist Education

“Lesson 12 is great for pharmacists interested in functional medicine consulting, pharmacogenomic and nutrigenomic testing, offering weight and hormone management programs!”

After three years of building the Pharmapreneur Academy, I finally have created a step-by-step model for pharmacists who want to offer cash-based services.

I’ve been resistant to do this since cash-based services take a different approach, may be targeted at a different patient demographic and can be a tougher “sell” for a budding entrepreneur.

As you’ll see in the E-Course Lesson Outline below, our LESSONS start at the beginner level and build up to the more advanced consultation services.

Cash-based services can be the most difficult to get off the ground, BUT these services can provide patients immense value and GREAT FINANCIAL rewards you without the hassle and oversight of insurance payers.

Back in March, when I started my Genetic Journey, I created a Genetic Consults business that I launched as a cash-based program to see if patients would be willing to pay for pharmacogenomic and nutrigenomic testing services.

I documented everything I did and everything I learned about offering a cash-based “health coaching” program.

In LESSON 12 of the e-Course at the Pharmapreneur Academy, I share everything I’ve learned about what works and what doesn’t about business, marketing and “selling” your cash-based services.

Lesson 12 is great for pharmacists interested in:

  • functional medicine consulting
  • pharmacogenomic and nutrigenomic testing
  • offering weight and hormone management programs
  • and even insurance-billed programs for diabetes like the National DPP and DSMT

LESSON 12 – Cash-Based Services – Online and Off

  • Pros and cons of cash-based services
  • Niches for cash-based services – In-person community setting
    • Diabetes
      • National Diabetes Prevention Program
      • Diabetes Self Management Training
      • Medical Nutrition Therapy
    • Genetic Testing
      • Nutrigenomic testing
        • Complimentary supplements
        • Examples of genes tested
      • Pharmacogenomic testing
        • Examples of genes tested
    • Point of Care Testing
      • See Lesson 9 for more information
    • Health Coaching
      • Weight management
      • antiaging/fatigue/sleep
      • Gene/drug induced nutrient depletion
    • Hormone Support Services
    • Travel consult services
    • Food sensitivity testing
      • Guided elimination diets
  • Delivering virtual services
    • Scope of practice considerations
    • Opportunities
    • Telehealth
      • definition
    • Remote Patient Monitoring
  • Pricing and Positioning of Cash Based Services
  • Branding    
    • Personal brand vs. Company brand
  • Building a website for virtual services
  • Marketing tips for your cash-based services

Can you see why I’m excited to release Lesson 12?

You’ve never seen a business training like this in the world of pharmacy!



Since we’ve gone through our most recent Lesson in the e-Course at the Academy, lets now take a look back at the first 11 Lessons.


  • Identify pros/cons of owning a business
    • Benefits of owning a business
    • Downsides of owning a business
    • Skills of the entrepreneur
      • Marketing
      • Networking
      • Rapport building
      • Creating systems
      • Building a financial foundation
        • Financial resources
    • Mindset of the entrepreneur
  • Learn your options for business structures
    • First steps to starting your business
      • Structure of your company
      • Opening a dedicated account
      • Choosing a name
      • Liability coverage concerns
      • Continuing education
  • Learn how to prepare your personal finances for entrepreneurship and protect your assets
    • Controlling your debt
    • Building an emergency fund
    • Planning for retirement
    • Disability/liability/life insurance coverage
    • Health insurance coverage


  • Examine different options for payment
    • Incident to codes (amb care)
    • Incident to codes (acute care)
    • RPh-specific codes
    • Medicaid programs for reimbursement of clinical services
  • Identify your target market – IDENTIFY 5 NEW LEADS
    • ACOs/Physician groups
    • Independent community pharmacies
  • Seek new opportunities
    • Collaborative Practice Agreements
    • Chronic Care Management Services
    • Transitional Care Management Services
  • Employee vs. independent contractor and how to GET PAID
    • Retainers vs. flat fees
    • Immunization clinic organizer
    • Diabetic educator
    • Implementation of new clinical services in community pharmacy
    • CCM/TCM services implementation in physician clinics
    • Pharmacogenomics/DNA testing services



  • Use the list of top 5 leads from Lesson 2
    • Think about your contacts
    • Use your network
      • Reach out to local COPs
      • Utilize social media
      • Build an online presence
      • Advertise locally
      • “Speak” your brand
  • Develop a marketing plan for ideal customer
    • Provide education and value for them
      • Improve Star ratings (community pharmacies)
      • Improve patient loyalty
      • Improve patient outcomes
      • Save money
      • Decrease readmissions
      • Decrease ADEs
      • Improve PQRS measures (physician groups)
    • Consider putting on workshops in your area of expertise
  • Be able to explain exactly how you can help them
    • Develop an “elevator pitch”
    • Identify their pain points
      • Include how you can help improve workflow efficiency
      • Design a ready to implement MTM program
      • Design a read to implement CCM/TCM program
  • Begin contacting your ideal leads
    • Example “pitch”
      • Includes phone script
    • Take detailed notes
    • Tailor your presentation material to suit the audience and use their pain points
    • Sample slide presentations, infographics, flyers, marketing materials etc. (shared in The Academy Forum)



  • Launch your services
    • Contact your idea leads in your target market
    • Make appointment for presentations
    • Follow up with leads
  • Plan for implementation
    • Implementation timeline (shared in The Academy Forum)
    • SWOT
    • One month implementation strategy
    • Prepping the pharmacy for clinical services
  • Learn staff training skills
    • Orienting the staff to MTM
    • Marketing the new service
    • Templates for lab requests/patient worksheets/etc (shared in The Academy Forum)
    • Creating shareable documents/emails accounts/worksheets
    • Step-by-step technician training protocols
      • MTM Lead Technician
        • Responsibilities
      • MTM Lead Pharmacist
        • Responsibilities
  • Get set up with MTM platforms
    • Authorized users
    • Access to all shareable documents
  • Getting patients to agree to CMR
    • Utilize training call scripts
      • Sample scripts


  • Starting the service
    • Identify potential workflow issues
    • Plan for “batching” CMRs
    • Med-sync programs/other clinical services to offer alongside MTM
    • Protocol for prep work
  • Schedule “test” patient appointments
    • Handling patient communications
    • Handling prescriber communications
    • Troubleshoot first patient appointments
    • Utilize universal scheduling system
  • Implementing organizational systems
    • Protocols
    • Filing systems
  • MTM Platform Crash course
    • Mirixa
    • OutcomesMTM
    • Clinical resources
  • Identify other potential revenue streams
    • Ask for feedback from patients
    • Develop a follow up plan
    • “Test sell” new services
      • PGx testing programs
      • Physician consulting collaboration


  • Excelling at your work
    • Over deliver
    • Believing in yourself
    • Ask for feedback
  • Treat yourself as CEO
    • Value your time
    • Seek personal growth
    • Continue your education
    • Find solutions
    • Validating new business ideas
  • Seek new opportunities
    • Social media
    • Websites
    • Online presence
  • Growing your business
    • Learn to pivot
    • Scale your business
    • Look for help
    • Hire assistance if needed


  • What is CCM?
    • Definition of CCM
    • CPT codes for CCM
      • Reimbursements for practitioners
    • Reimbursement models in practices
      • Eligibility
      • Who bills? How?
      • How to contract with physicians
    • Medicare compliance REQUIREMENTS
      • Initial E/M
      • 20 min non face-to-face
      • Eligibility
      • 24/7 patient access
      • Patient consent
      • EHR requirements
  • How to set up clinics
    • How to set up appointments
      • Sample appointment card
    • Marketing
      • Why physicians would want to hire you?
    • Presentations
      • What is CCM and performance measures?
        • Sample PDF of my slides shared in the Academy Forum
      • Choosing high risk patients
    • Introducing your services
      • How you are going to improve their program?
      • Marketing your services
        • Patient examples
  • Practice management
  • Best practices for CCM
    • Workflow model
    • Identifying target patients for maximum outcomes & reimbursement
      • How to enroll
    • How to utilize G Codes
    • Chronic Care form to use that exceeds Medicare standards to bill
    • Multidisciplinary team
      • Developing a comprehensive care plan
  • The 12 components of CCM
    • ​Sample Care Plan
  • ​Adding CCM services to your consulting toolkit
    • Turn-key software options
    • 24/7 help and a seamless software platform
    • Gets you in the door with providers
    • Provides support and training
    • Certified EHR


  • Collaborative practice agreements
    • Preamble
    • Pharmacist
    • Provider
    • Definition of patient
    • Definition of communication style
    • Special considerations/restrictions
    • Hold harmless clause
    • Expiration date (12 months)
    • Signatures
  • Codes to use for MTM services
    • Incident to codes 99211-99215
    • Pharmacist-specific MTM codes 99605-99607
  • Transitional Care Management codes 99495 & 99496
    • Documentation
    • Billing example
    • Expected reimbursement
    • Limitations
  • TCM/CCM Overlap


  • Point of care testing
    • Definition
    • Opportunities
    • Examples
    • CLIA waivers
    • Patient education
    • Pharmacist education
    • Getting your site ready
    • Best practices for workflow
  • Types of Point of Care Tests
    • Rapid diagnostic tests
    • Screening tests
    • Treatments associated with testing
    • Scope of practices considerations
    • Billing
  • Pharmacogenomic testing
    • Definition
    • Commonly tested genes
    • Commonly impacted medications
    • Benefits
    • Opportunities
    • Testing process
    • Payment/billing
  • MTM & PGx
    • Integration of Pgx into an MTM program
    • Impact on patients
    • Marketing the service
    • Labs to work with



  • AWVS
    • Codes
    • Components of initial visit
    • Components of subsequent visits
    • Opportunities in AWV to offer additional services
  • Preventative services modifiers
    • Advanced care planning
    • Alcohol misuse screening/counseling
    • Tobacco cessation screening/counseling
    • DSMT
    • Intensive behavioral therapy for cardiovascular disease
    • Intensive behavioral therapy for obesity
    • Medical nutrition therapy
    • Annual depression screening
  • Vaccinations for medicare patients
  • ROI for AWVs
  • Update on CCM services
    • Complex codes



  • Prescriber Detailing 
    • Identify prescribers
    • Establish relationships
    • Set up an in-person appointment with the provider and staff if possible.
    • Be prepared to explain how your pharmacy’s existing services can help them meet their MIPS performance goals.
    • Focus on ways to streamline prescriber workflow.
    • Quality – 50% weight in MIPS
      • Interventions:
      • Advancing Care Information -25%
    • Cost/Resource Use – 10%
    • Improvement Activities – 15% weight in MIPS
      • Improvement Activity
        • examples
  • MIPS clinics
    • Chooses 6 measures
  • APM clinics
    • Assigned 15 measures
  • HEDIS measures
  • Medication Non-Compliance Diagnoses
    • Z91.19

As you can see, there is something for everyone in the E-Course at the Pharmapreneur Academy.

All these trainings and much more are included for free with your membership.

To join before December 31st, go to and get INSTANT ACCESS for only $197!

Still have questions?

Join our next live webinar “What’s Working in Consulting in 2019” on Sunday, January 6th at 8pmCST.

About the Author

Blair Thielemier, PharmD, is a business development consultant specializing in pharmacist-led billing models. She has set the industry standard for virtual pharmacy conferences with the Elevate Pharmacy Virtual Summit in 2017. She has consulted with national pharmacy organizations, drug wholesalers, point of sale companies, and Fortune 5 health insurers. She has books and online courses available for individuals looking to leverage their pharmacy knowledge into monetized clinical programs at She speaks internationally about trends in leveraging pharmacists to improve value-based care.


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