Full course description
Successful Implementation of Patient Assessment
and Proper Billing
This program is based on the billing components and processing construct built in the State of Oregon. This came about in response to the Legislature’s direction to have pharmacists’ accessibility leveraged to increase access to hormonal contraceptives in Oregon. As a public mission-based educational institution, Oregon State University College of Pharmacy often works at the behest of the Oregon state legislature and the Oregon Health Authority in service to the state. This program was created to support Oregon’s pharmacist prescribing and billing initiatives. The patient assessment and ensuing billing, places pharmacists in the realm of medical billing. The billing mechanics presented here place pharmacist’s clinical assessments in the same category as all other medical practitioners who assess patients.
Topics covered in this course provides an overview of the healthcare payer environment in the United States, recognize how Medicaid is administered, credentialing/enrollment and billing mechanics utilized to build a pharmacist prescribing and reimbursement model, and the fundamentals of medical billing including HCPS, CPT and ICD10 codes.
Upon taking this course, pharmacists will recognize the professional implications, including the audit responsibility, in the utilization of billing codes and the associated liability. It is imperative pharmacists be fully trained on the elements that must be present and exhibit professionalism when properly utilizing billing codes.
Upon successful completion of the post-exam, a pharmacist will be able to print a Certificate of Competence in the Successful Implementation of Patient and Assessment and Proper Billing. This attests to the pharmacist’s understanding of billing context and assumption of Professional Responsibility. These concepts and content will also apply similarly in additional states who enable pharmacists to assess patients and bill for those services. To bill as a provider for assessment and prescribing billing services in other states, the individual pharmacist and pharmacy will need to engage with their credentialing and enrollment state processes.
Accreditation Council for Pharmacy Education Information:
This program has been planned and implemented in accordance with the policies of the Accreditation Council for Pharmacy Education through the sponsorship of OSU College of Pharmacy. The OSU College of Pharmacy is approved by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Upon completion of this activity, participants will receive a Certificate of Completion, and a Statement of Credit shall be uploaded to CPE Monitor. Completion requires 1) Registration for the course 2) Completion of all modules and 3) Completion of the program evaluation.
Activity Type: Knowledge
Activity Release Date: 7/1/2019
Activity Expiration Date: 7/1/2022