Pharmacist Medical Provider Credentialing and Contracting 101
July 10, 2020
In 2017, Tennessee enacted Public Chapter 82, paving the way for pharmacists to be credentialed and reimbursed as medical providers in commercial health plan medical provider networks. Following on the heels of the enactment of a similar law in Washington state in 2015, Tennessee became only the second state to enact such legislation granting pharmacists recognition and payment as “providers”. Since the enactment of these important laws, similar laws have been enacted in additional states to increase patient access to compensated pharmacist-provided patient care services.
Continuing Education: Building a Patient-Centered Practice
TPA has developed a web-based educational training program to support pharmacists in developing a patient-centered pharmacy practice. This web-based training program provides pharmacists and pharmacy technicians with three (3) hours of ACPE-accredited continuing education focused on key aspects of pharmacy practice development.
Program Title: Building a Patient-Centered Practice: Collaborative Practice, Credentialing and Provider Enrollment, and Opportunities for Pharmacists Presenter: Dr. Micah Cost, PharmD, MS Audience: Pharmacists and Technicians Objectives:
- Review of collaborative pharmacy practice laws, rules, and policies in Tennessee,
- Discuss key concepts related to pharmacist credentialing and contracting
- Provide an overview of pharmacy practice advancement opportunities
- TPA Member Pricing: $79
- Non-member Pricing: $99
Type of Activity: Knowledge-based UAN: 0575-0000-20-087-H04-P/T Contact Hours: Upon completion of this webinar, participants will receive three contact hours (0.3 CEU) of ACPE-accredited continuing education credit Release Date: 06/21/2020 Expiration Date: 06/21/2023
Tennessee Pharmacists Consortium for Education is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education
|Purchase the “Building a Patient-Centered Practice” Training Program|
To help pharmacists succeed as medical providers, TPA has worked with the Washington State Pharmacy Association (WSPA) to develop a Tennessee-specific reference guide that shows you how to appropriately document, code, and bill for services.
The Tennessee Pharmacy Practice Guidebook is intended for licensed pharmacy professionals practicing within Tennessee. It serves as a reference book for Tennessee pharmacy professionals interested in learning why documentation is so critical for reimbursement and audit mitigation; how to utilize different billing methods; and how to utilize appropriate billing codes within a pharmacist’s scope of practice.
The guidebook includes:
- Documentation for time and complexity-based billing methods
- CPT® and ICD-10 Diagnosis codes for claims submission
- Case studies showing how to translate documentation to billing code
Our digital version of the TPA Pharmacy Practice Guidebook is now available for purchase here. TPA members receive a 25% discount on the purchase of this important resource, which retails at $149.99.
Retail Price: $149.99
- TPA Members (25% Discount): $112.49
- TPA Non-Members: $149.99
Your guidebook is conveniently accessible when you need it, whether you are working in the office or remotely. Your digital guidebook is accessible using either a PDF, an IPAD, or HTML Cloud Reader. You can download the digital PDF three times, allowing you to save it on multiple devices. In addition, you can use a cloud-based interactive platform with HTML. All you need is an internet connection. While you can view the guidebook in multiple formats, only one person can view it at a time. If you need multiple access simultaneously, we recommend purchasing additional digital guidebooks to better meet your needs.
Now that pharmacists can join commercial health plans and be reimbursed as medical providers, TPA is committed to helping you succeed as providers. If your organization is considering providing medical services, this guidebook will become your reference guide for documentation and coding clinical services