If you own or run a pharmacy, then you might have thought about working with a PBM contracting service. As you are probably already aware, these companies work with both pharmacies and health insurance companies. Basically, their job is to help pharmacies like you to connect with health insurance companies that are interested in adding more pharmacies to their network. Then, their customers can come to your pharmacy to purchase covered medication.
It isn't impossible to work with insurance companies yourself when coming up with these contracts. It also isn't impossible to run a successful pharmacy without ever signing a contract with a health insurance company. However, overall, you will probably find that you can avoid the issues below and more if you work with a PBM contracting service.
Lack of Customers
Right now, you might be struggling to maintain a successful pharmacy since you might not really have enough customers. If this is the case, there are a few different things that you can do if you want to bring in more customers. For one thing, you should consider working with a PBM contracting service. Then, once the service helps you connect with multiple insurance companies, then you can potentially bring in a lot of customers who have insurance through those companies. Doing this — along with marketing your pharmacy in various ways, both online and locally — can help you bring in more customers and higher profits.
Problems With Negotiating Contracts
You might like the idea of negotiating contracts with insurance companies, but you could be thinking about doing it on your own. However, you might find that you will be a lot more successful — and that you will receive higher payments from the insurance company — if you work with a PBM contracting service in order to negotiate these contracts.
Billing Issues With Insurance Companies
Of course, if you are going to work with insurance companies so that you can provide drug benefits to their policyholders, then you are going to have to bill those insurance companies so that your pharmacy can receive the payments that it is entitled to. Setting up everything for billing can be challenging, and it's possible to make mistakes along the way that could cause issues either for your pharmacy, the insurance company, or both. A PBM contracting service can talk to you a little bit about billing and may even provide you with resources so that you can get everything set up properly. Then, you can help minimize issues when billing each insurance company. Then, hopefully, everything will go a lot more smoothly.