Pharmacy Billing Services

Introduction of Our Pharmacy Billing Services!

Are you finding it increasingly challenging to navigate through the complexities of pharmacy billing while striving to maintain competitiveness in today’s dynamic market? Look no further! Backbone Data Solutions is here to revolutionize your pharmacy billing management with our cutting-edge solutions tailored to meet your unique needs.

We can provide you with world-class and accurate pharmacy billing services that will accelerate your billing procedures by automatically calculating discounts, taxes, postings, reimbursements, etc. We can also help you strengthen your billing systems and insert the right codes for accurate billing.

Pharmacy Billing Process We Follow

01. Receive Mail Order

In the first step, we receive the mail order from the Pharmacy Benefit Management (PBM) team via Opex or any other FTP/scanning tools. The team would negotiate costs with the manufacturer for better discounts.

02. Details Verification

Once the negotiations are done, our team of pharmacy billing experts will verify all the patient details such as name, address, SSN number, and dependent information, etc., and the physician details such as name, NTI number, etc.

03. Data Conversion Entry

Each document is scanned, classified, and converted to a system-readable format from the original scanned format.

04. Medication Refill Check

Once the data is converted, the medication refill status is checked which will help in understanding the required quantity of medication considering the duration of the prescription.

05. Organizing Prescribed Medicines

In this step, we find the exact brand name of the prescribed medicines and suggest the generic names of the molecule, cutting down the costs even further.

06. Order Placement

If the medicine prescribed is generic, then we go ahead and place the order in the client’s software. A copy of the order will be sent to the insurance company and one to the patient. For emergency kits, the order is usually placed within 30 minutes of receipt.

07. Order Tracking

We have a dedicated team to keep track of the consignment till it is delivered to the patient. The escalations are followed in cases where the delivery is delayed at the logistics end.

08. Billing Management

Once we receive the check for payments, we update it into the billing management system and send our reminders for the due dates of the payment. Apart from this we also provide AR follow-up and payment posting services if required.

Pharmacy Billing Solutions We Offer

We provide a comprehensive range of pharmacy billing solutions, including –

Daily Census Updates

Census maintenance is a very important function from a medical billing point of view, as it involves creating proper records of the patient and the payee. It involves recording information of patient discharges, change of physicians, etc. All this is essential especially if your customers plan to make a medical claim.


Admission is the first step in the medical billing process and involves recording the details of the patients like their name, age, blood group, medical history, diagnostic reports, previous prescriptions, known allergies, etc.

Prior Authorization Document Management

The billing management systems we develop ensure that complete authorizations are taken before the processing begins. This ensures that patients are always covered by a health plan and there are minimal claim denials. Our authorization systems are set to handle every drug category and emergency levels.

Refills Management

Refill management is another area that requires great attention and quicker action, as your customers are not going to be very patient with you the second time they come around. As a top pharmacy billing services company, we will help you set up all the necessary approvals and reminders so that when a customer comes in for a refill, you can process it right away without any delay.

AR Follow-Up

We know that every small service that doesn't get billed impacts your bottom line directly, so we take care and handle it with a lot of attention. The most important aspect of this service is to ensure that only services performed are captured and billed at the right time.

Payment Posting

This is probably the most labor-intensive activity in pharmacy billing, but the good news is that we can automate it. We will help you streamline the manual payment postings, automatically post the insurance payments, and reduce the data entry time.


Why Are We The Preferred Pharmacy Billing Services Company?

We are an ISO-certified and RBMA Corporate Partner. All our processes are HIPAA, ICD-11, and DSM 5 compliant. Our pharmacy billing support executives are well-trained and follow recommended billing procedures to ensure data confidentiality.

We understand the importance of safeguarding patient data when it comes to pharmacy billing. Apart from signing confidentiality agreements, we also conduct regular audits to ensure that all client data is 100% secure with us, and not compromised at any cost.

Be it an A-rated generic drug or branded/unbranded drugs, we have professionals who understand the nuances of pharmaceutical drug categories. The broad knowledge allows us to handle a variety of documentation with unmatched quality and precision.

We deliver reliable pharmacy billing services and reports within a quick TAT. You can save 35% of the time on other key concerns while we handle pharmacy billing service.

We render custom billing solutions with an eye on future needs. As your business evolves, you may face higher billing volume and complex regulatory compliances. This will be completely taken care because our billing solutions are designed to handle scaling demand.

If you wish to consult and converse with one dedicated handler rather than many, we have heard your concerns. Since the person appointed to interact with you is well-advised about the project, the updates you need can be availed on tap.

Pharmaceutical billing involves a mix of functions with various criticality. Since the onus of handling these functions in an efficient manner is on us, we use advanced pharmacy billing software that streamlines the performance with accuracy and finesse. 

Backbone Data Solutions is a pharmacy billing outsourcing company that has been providing We have a trained, skilled, and experienced team of pharmacy billing experts capable of handling any billing management requirement within a quick turnaround time.

Our team of pharmacy billing experts has access to the best infrastructure in terms of world-class office spaces, uninterrupted network facilities, and state-of-the-art billing tools and technologies. This helps us offer the best services to our clients at a faster turnaround and the most affordable rates.

We use some of the most secure methods such as FTP to transfer files. Our team can also remotely log into your system and work on the files if you prefer not to send over the files and want the work done on your own machines.

We assign a dedicated project manager to every client who will keep them updated with the project status regularly. Additionally, they will be available via email, chat, or phone to solve any client queries during your work hours no matter what part of the globe you are in.

When you outsource pharmacy billing services, the requirements can vary depending on your business needs. Hence, we provide you with customized pricing models which will exactly suit your requirements.

Outsource Pharmacy Billing Services to Us - The Leader in Medical Billing and Coding

We understand that no one likes faulty, lethargic pharmacy billing solutions that take more time than the medical procedure itself. You need a system that automatically calculates and iterates the taxes, discounts, reimbursements, and postings, and we are here to help you customize one. We have always developed systems that have exceeded industry benchmarks.

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