This is one of my favorite strategies to reduce reliance on PBMs while dramatically increasing your pharmacy’s profits. For your worker’s compensation claims, you can ditch the PBMs and their terrible reimbursements and instead bill the work comp carrier directly. The work comp insurance pays the same amount no matter who bills them, but when you bill directly, you get the full amount allowed by law rather than the pennies the PBMs will pay you.
My favorite direct biller for work comp is StreamCare. Lloyd is amazing to work with and will walk you through their easy process step-by-step. In my opinion, StreamCare is the most aggressive at billing and ensuring you can direct bill as many carriers as possible.
The back-end work is simple and easy. It takes only a few minutes to set up.
Here’s a canva template link to create Work Comp Flyers in your pharmacies. Click HERE.
Direct billing work comp claims works in most states, currently at 42. To see if your pharmacy qualifies, go HERE and fill out the quick form.
