Improving revenue collection for ambulatory pharmaceutical services.

A method of improving revenue collection for ambulatory pharmaceutical services was studied. Data were collected and compared from two phases. In Phase 1, all charges for outpatient pharmaceutical services were billed by the business office. During Phase 2, a pharmacy-based cash-and-carry policy was initiated; patients were encouraged to pay for their prescriptions by cash, check, or credit card, and third-party agencies were billed directly for prescriptions when patients had such coverage. Samples of 1000 prescriptions were randomly selected in each phase to determine the amount of charges collected. Criteria for inclusion of prescriptions were the same in each phase. For the 831 prescriptions meeting the study criteria in Phase 1, 46% of the total $895,812 in charges was collected. For the 767 prescriptions meeting the same criteria in Phase 2, 85% of the total $892,185 charges was collected. It required an additional 1.5 minutes for the pharmacy to process a prescription in Phase 2. Patients receiving emergency medical services and those covered by Medicare had the poorest collection rates. The highest rates occurred for patients covered by Medicaid and those receiving maintenance medication. The cash-and-carry policy notably improved revenue collection and the efficiency of the collection process for outpatient pharmaceutical services.