Advancing The Profession of Pharmacy

What Provider Status Would Do for Pharmacy

by | Oct 26, 2016 | Consulting Pharmacist Education

 

To put it simply, we still need to build our business and refine pharmacist-led clinical services.

Spending a weekend at NCPA annual meeting 2016 was one of the most exhausting and invigorating experiences in my career.  The overarching theme of the conference was how independent community pharmacy can  set itself above and apart.

One way to accomplish this elevation of the profession is undoubtedly through offering enhanced clinical services.  

This means offering services that go beyond the scope of a “required” MTM intervention.  It also means finding innovative ways to collaborative with providers to offer services such as transitions of care, chronic care plan management, point of care screenings and testing, annual wellness exams and precision medicine consultations.

 

How would provider status change these services?

Well, it wouldn’t.  The work would still have to be done.  Policy and procedures created.  Relationships with physicians cultivated.  Collaborative agreements drawn up.  Essentially the process of creating, implementing and offering enhanced clinical services would still be EXACTLY the same.

Surprised?

Provider status will not be a magic bullet.  

​It will not mean you can set up shop in your own clinic and start seeing patients of your own.  It will also not mean pharmacists will be given prescriptive authority.  Of course, it is a VERY encouraging step towards it, it does not instantly guarantee it.

In fact, over 30% of pharmacists polled say they do not feel adequately prepared to respond immediately to provider status.

No, much to the chagrin of many.  It will still require a heck of a lot of resources, networking and entrepreneurial stamina.

So, what will it change?

Quite simply, it will make billing insurance for our services much, much easier.

Currently, we have a few billing options, but they always requires the use of someone else’s NPI.  

Provider status would streamline the billing process for pharmacists’ services.

Right now, billing is possible.  However, some providers and medical billing teams are wary of the using the work-arounds.  Provider status for pharmacists would go a very long way toward giving them peace of mind concerning insurance audits.

To put it simply, pharmacists will still need to be prepared to build our business and refine pharmacist-led clinical services.

Provider status won’t offer us patients on a silver platter.  Additionally, those that are waiting for it to happen will get stuck behind the curve.

Pharmacists who start working on their clinical services NOW, however, will be poised and ready to take full advantage of the OPPORTUNITY provider status will bring.

This new blog series will focus on tools that help community pharmacy implement and integrate enhanced services. 

This new series is called the Community Pharmacy Toolkit

Some of these tools focus on streamlining workflow, integrating new services,  improving interoperability, making for easier documentation or even just some services that I think are really cool.

*These opinions are my own, and they are just that: MY OPINIONS.  I am not being reimbursed for featuring these tools, I only want to share them with my colleagues in community pharmacy and the pharmacy consultants they work with to advance the profession of pharmacy.

If you’d like to stay up to date and be notified of each new article in this series, join the Pharmapreneur Community Newsletter.

About the Author

Blair Thielemier, PharmD, is an MTM consultant pharmacist specializing in pharmacy billing models. She consults on and produces e-learning programs for state and national organizations, pharmacy wholesalers, payers, technology start-ups. She has books and online courses available for individuals looking to leverage their pharmacy knowledge into monetized clinical programs at PharmapreneurAcademy.com. She speaks internationally about trends in leveraging pharmacists to improve value-based care.

 

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