As you read this post, COVID-19 is not new to the news cycle. In fact, if you’re feeling anything like us, it’s probably getting a little old. But through it all, we’ve witnessed pharmacies rise to the unique challenges presented by the pandemic, proving that they are the ideal centers of care for everything from vaccines to preventative and primary care.
Just as the preferred setting of care for COVID-19 immunizations shifted to the pharmacy as government-run mass vaccinations site shut down, we are about to see a similar, seismic shift towards the pharmacy as the preferred setting of care for COVID-19 tests.
Whether you’ve been providing COVID-19 testing for some time now or are looking to add this service, now is the time to ensure you have the right processes in place to support and most importantly, get reimbursed, for COVID-19 testing.
We hear pharmacies across all markets, regions and states asking the same questions regarding COVID-19 testing processes – enter our testing playbook. Within the playbook is a workflow-style guide you can follow to effectively operationalize COVID-19 testing in your pharmacy.
First, and foremost, to execute COVID-19 testing successfully, efficiently and at scale.
Secondly, while this playbook is designed with COVID-19 in mind, it can be easily adapted to cover any point-of-care testing you do in your pharmacy.
We know, it’s a lot. Here’s a sneak peek of what’s inside. Don’t need the sneak peek? Get your copy now.
We are still outside the four walls of the pharmacy, but now your patient knows that you provide testing and is ready to get tested for COVID-19. What’s next? Scheduling. There are a couple of key considerations here.
What data are you capturing from patients during the intake process? We recommend capturing at least basic demographic data like date of birth as well as medical insurance information.
Are you screening for medical necessity? For COVID-19 testing, patients don’t have to meet a certain threshold of medical necessity in order for you to perform the test, but you are still required to document medical necessity. If you’re providing other point-of-care tests (like the flu), it is critical to screen patients for medical necessity as part of the scheduling process. Look for a scheduler that can send screening questions to your electronic health record to determine and document medical necessity.
Do I contract as a provider or organization?
How many payer contracts do I need?
Do I need to be contracted as a lab?
How do my patients know I offer point-of-care/COVID-19 testing?
How do I communicate this new clinical service with patients?
What documentation does my scheduler pull before the test?
How am I communicating that data forward for a good patient experience?
Where are my patients waiting for test results?
How will the physical set up of my store allow me to successfully execute COVID-19 testing procedures?
How do I document the clinical encounter to ensure accurate reimbursement?
How do I prove medical necessity, if needed for COVID-19 testing?
How do I process test results?
How do I communicate test results?
How do I bill payers?
Which payers can I bill through?
What codes must I use to ensure proper reimbursement?
What federal reporting requirements exist for COVID-19 testing in pharmacy?
What about state or local reporting?
How do I report test results and next steps?