Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Pharmacists’ prescriptive authority varies. In North Dakota (ND) pharmacists have limited prescriptive authority for immunizations and tobacco cessation therapies, yet billing presents many barriers. Barriers include time to bill, ease of billing, payer recognition, and reimbursement of services.
Research Question or Hypothesis: This study aimed to explore barriers and identify facilitators to billing for pharmacist-provided clinical services in ND.
Study Design: Survey research of licensed ND pharmacists to determine the current state of billing practices.
Methods: The survey was sent to all ND pharmacists with an e-mail address on file with the ND Board of Pharmacy. Descriptive analysis identified trends in current billing practices, billing code utilization, barriers to billing, and pharmacists’ perception of appropriate reimbursement. Data was further divided into rural and urban findings.
Results: 236 pharmacists responded: 50 rural, 102 urban, 83 undetermined. 38% of rural pharmacists billed for services, 28% did not, 34% did not respond. 33% of urban pharmacists billed for services, 36% did not, 30% did not respond. 20% of rural pharmacists felt reimbursement from billing sustains their services and 40% did not. In urban areas, 25% felt reimbursement sustains their services while 43% did not. Most billing codes used were medication therapy management (MTM)-related, with <5% for tobacco cessation. A barrier to pharmacy billing utilization is time. 26% of rural and 16% of urban pharmacists do not use support personnel. Pharmacists without support personnel lack time to provide billable services submit claims.
Conclusion: Pharmacists in ND can bill for limited services; however, this survey shows most only utilize MTM billing. Many barriers were identified such as time to bill, ease of billing, payer recognition and reimbursement. Sustainability of services is vital for implementation of any service and can be overcome with increased billing implementation. This research seeks solutions to overcome barriers and examine efficient ways for pharmacists to bill and implement new services.
Presenting Author
Natasha Petry PharmD, MPH, BCACPNorth Dakota State University
Authors
Conner Armstrong PharmD
North Dakota State University
Joy Dahlen PharmD
North Dakota State University
Brody Maack PharmD, BCACP, CTTS
North Dakota State University/Family HealthCare