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their existing systems. DME often does not work that way.
“A retail pharmacy’s work ow cycle is much shorter, from receipt of prescription
to the claim adjudication and, ultimately, dispensing the medication,” says Jason Jacobs, COO of post-acute software company VirtueRN. “The pharmacist has the ability to immediately see if the claim will be paid and what will be paid by the insurance carrier prior to dispensing a medication. They have the ability to reverse the claim if the margins are poor and not dispense the product for the amount being reimbursed. DME providers do not have the ability to do this.”
What that means in information tech- nology terms is that handling DME may seem backward to a pharmacist or phar- macy tech.
“Pharmacy does all the records and docu- mentation ahead of the purchase. For DME it is done afterward,” Crane says. “In the pharmacy world, before the patient gets to you, you know the product is covered. You collect from your patient before you ever hand them anything. DME is the opposite. We call it ‘bill by face.’ You don’t know sometimes until months and months down the road if you will get paid” by Medicare or an insurer. “Sometimes your claims never get paid. The patient is gone and you never get paid for it. It is a scary adventure. When you add pharmacy to DME there are more rules and regulations to follow but you know you’ll get paid.”
Get Your Software Vendors to Cooperate
If you are married to the system on which your shop is running today, ask your provider if they have a DME module you can add to it. If your provider does, it might be worth the upgrade, but unfortunately, most don’t. The next option is to ask the DME provider if they will work with your pharmacy software providers to create an interface with your legacy system.
“There can be barriers and legacy issues integrating any software. The existing software provider’s willingness to support their platform for integration can sometimes be a challenge, particularly if the platform
is older,” Jacobs says. “Whatever system
of record that pharmacy has, it really boils down to the company that sold \[you\] that system ... Some will integrate with any solu- tion. There may be a charge that some tech companies pass along, but it varies from company to company.”
To make your pharmacy and DME soft- ware work together, “You would have to add on a DME module, or you might have to have an entirely different software program that has an API (application program interface)
feature,” Crane advises. “It would be really dif cult to nd a product that is affordable and meets all the needs.”
The most important component in his scenario would be a shared patient data- base, so both systems work from the same set of patient records.
“When you think about how your infor- mation is stored in a database, you have all this information that you are backing up and maintaining,” Crane says. “There may be new database information that might have to be updated. If it is entirely new, then you have two databases.”
Tired of your pharmacy management and HME systems not sharing?
Only QS/1® o ers total integration between our
pharmacy management, HME and POS systems.
Your multifaceted pharmacy doesn’t have to include multiple systems that don’t communicate. QS/1’s total product integration eliminates duplicate entry with shared doctor and patient les. Documentation entered into our NRx® or PrimeCare® pharmacy systems automatically transfers to our SystemOne® HME solution for billing. And, the POS system helps ensure date-of-service compliance for Medicare Part B. These integrated systems seamlessly manage orders, documentation, claims and inventory – helping you maintain compliance, e ciency and pro tability.
Bring It On. Whatever your challenge, QS/1 has a solution.
To learn more about how QS/1 can integrate your pharmacy and HME business, visit
www.qs1solutions.com/HME-Rx-integration, call 866.910.9734 or scan the code below.
©2018 J M SMITH CORPORATION. QS/1 is a registered trademark of the J M Smith Corporation.
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DME Pharmacy | April 2018
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