Question 1

WHEN DO I GET PAID ON MY CLAIMS?

Accepted Answer

Between the 1st and 5th of each month you will receive a reimbursement ACH directly to your account. If you prefer a check, you will receive this by the 15th of each month.

Question 2

ARE THERE LIMITATIONS TO WHAT MEDICATIONS I CAN DISPENSE?

Accepted Answer

We recommend utilizing generic medications when possible to keep your cost of goods low. Each state is unique for workers compensation. Some states have state specific formularies that restrict payment on specific medications. We help by providing our knowledge and experience to get you the highest reimbursements possible for your state.

Question 3

HOW LONG DOES IT TAKE TO GET REIMBURSED ON A CLAIM?

Accepted Answer

Each state has their own laws on how much time they have to respond with a denial or payment on a bill. On average we collect payments for claims 30 to 45 days from when they are billed.
 
There are several factors that play into the time range for getting paid on claims:
 
1. Electronic vs. USPS delivery. We prefer to bill claims electronically, although some carriers require that we send claims via USPS.
2. The bill was denied by the insurance carrier. We write an appeal in these situations and provide the insurance carrier with any necessary documentation for reconsideration of the bill for payment. This starts the claim process time over again.
3. The information submitted to our bin had an incorrect Date of Injury, Diagnosis Code(s) or the wrong insurance company information, causing us to have to research, correct and rebill.

Question 4

WHAT HAPPENS IF I DON’T KNOW THE DIAGNOSIS CODE(S), INSURANCE INFORMATION OR CLAIM NUMBER?"

Accepted Answer

Without this information we are not able to successfully bill out your claim. This information is necessary and will be required. If the claim number is not available, you can use the patient’s social security number in its place. The physicians office will have all the information you will need to bill out each patient. Usually all it takes is a quick call.

Question 5

WHAT ADDITIONAL INFORMATION WE MAY ASK THE PHARMACY TO PROVIDE?

Accepted Answer

We may reach out to you for prescription copies, physician treatment notes, etc. to send to the insurance adjuster.

FREQUENTLY ASKED QUESTIONS

WHEN DO I GET PAID ON MY CLAIMS?

ARE THERE LIMITATIONS TO WHAT MEDICATIONS I CAN DISPENSE?

HOW LONG DOES IT TAKE TO GET REIMBURSED ON A CLAIM?

WHAT HAPPENS IF I DON’T KNOW THE DIAGNOSIS CODE(S), INSURANCE INFORMATION OR CLAIM NUMBER?"

WHAT ADDITIONAL INFORMATION WE MAY ASK THE PHARMACY TO PROVIDE?

support@pbosrx.com

888-727-8879

FREQUENTLY ASKED QUESTIONS

WHEN DO I GET PAID ON MY CLAIMS?

ARE THERE LIMITATIONS TO WHAT MEDICATIONS I CAN DISPENSE?

HOW LONG DOES IT TAKE TO GET REIMBURSED ON A CLAIM?

WHAT HAPPENS IF I DON’T KNOW THE DIAGNOSIS CODE(S), INSURANCE INFORMATION OR CLAIM NUMBER?"

WHAT ADDITIONAL INFORMATION WE MAY ASK THE PHARMACY TO PROVIDE?

support@pbosrx.com 888-727-8879

support@pbosrx.com

888-727-8879