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PrescribeWellness Debuts PrescribeCare Managed Service Organization (MSO), the First Nationally Integrated MSO for Community Pharmacies

PrescribeWellness, the cloud-based services company whose mission is to inspire collaboration for better health, today announced that it has debuted PrescribeCare Management Services Organization (MSO), a new pharmacy-facing MSO with enhanced capabilities to provide billing and revenue cycle management services. The PrescribeCare MSO negotiates reimbursements and contracts with health plans, payers and ACOs on behalf of community pharmacies so they can participate in risk-based, value-based and shared-savings contracts.

The new MSO also includes an online platform for pharmacy providers to enroll in state Medicaid medication therapy management (MTM) initiatives. As a result of these enhanced capabilities, the PrescribeCare MSO is now approved by Michigan’s Medicaid program as a third-party administrator to provide revenue cycle management services to Medicaid-participating pharmacy providers seeking to enroll in the Michigan MTM reimbursement program.

“The PrescribeCare MSO was created to help community pharmacies go ‘beyond the fill’ by collaborating with other healthcare providers to improve the quality of care for the patients they serve,” said Al Babbington, CEO of PrescribeWellness. “With its newly increased functionality, more community pharmacists will be able to participate in MTM initiatives—in Michigan and elsewhere. We are thrilled to be helping them provide such an invaluable service.”

A new and improved MSO

The new PrescribeCare MSO includes an online platform for pharmacy providers to enroll in state Medicaid medication therapy management (MTM) initiatives, conduct MTM benefit verification, engage patients and schedule appointments, file MTM consult documentation, and submit claims for reimbursement.

The PrescribeCare MSO also provides:

  • Collaborative Practice Agreements contracting
  • Clinical guidelines support
  • Daily patient management via the PrescribeWellness technology platform
  • Pharmacist clinical services billing support
  • Reporting and evaluation support
  • Tools to optimize STARS and HEDIS measures
  • Tools to optimize patient engagement

As a member of the PrescribeCare MSO, pharmacies can drive new revenue streams and receive per member per month (PMPM) payments, shared savings and performance-based reimbursements. It also offers information technology and automation tools to support reporting, coding, billing, collections and other administrative tasks.

Facilitating reimbursable MTM in Michigan—and beyond

Community pharmacists are the leading advocates for reimbursable MTM services, as they play a critical role in improving the health of their patients and community. But pharmacy providers are facing administrative challenges with enrolling and managing multiple MTM programs. To date, the Michigan Medicaid MTM program has enrolled 120 pharmacies, but there are over 9,000 pharmacy providers in the state that may be eligible to participate in the program. The PrescribeCare MSO is integrated with the Michigan Medicaid program and will be able—as a third-party administrator—to remove the administrative challenges for pharmacy providers.

Pharmacists in Michigan interested in participating in the Medicaid MTM program can sign up for the PrescribeCare MSO, which will handle credentialing, engage patients, schedule MTM consults, document patient encounters, and prepare and submit claims to ensure the pharmacy provider is paid—up to $365 per patient, depending on MTM services.

The PrescribeCare MSO has a dedicated reimbursement hotline—(800) 479-8200—for pharmacy providers to request enrollment in the service and to obtain answers to billing questions. Support is also available by email: [email protected].

Existing community pharmacy providers in Michigan that are already PrescribeWellness customers will receive communication about the new program, which will be accessible via the Patient Engagement Center module.

“As more state Medicaid programs add MTM as a benefit, the PrescribeCare MSO will be able to perform key administrative services on behalf of participating pharmacies to ensure compliance and secure reimbursement,” said Mindy Smith, VP of Pharmacy Practice Innovation at PrescribeWellness. “This will help minimize the time pharmacists have to spend on managing paperwork and free them up to spend more time caring for their patients.”

About PrescribeWellness

PrescribeWellness inspires collaboration for better health across America by connecting patients to locally owned community pharmacies. Its proprietary cloud-based platform empowers pharmacists to provide more effective preventive healthcare services, which improve medication adherence, chronic disease management, transitions in care, and population health. With data integration and behavioral science at the foundation, PrescribeWellness software solutions position the pharmacist at the center of community healthcare prevention. Inc. 5000 named PrescribeWellness one of America’s Fastest Growing Privately-Held Companies for the past three years. For more information, please visit www.prescribewellness.com.

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