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ABOUT

Our Story

Pharmacy First was founded in 1996 with the central goal of providing the appropriate programs and services needed to help independent pharmacies be successful. Recognizing the need of independent pharmacies for assistance with third-party-contracts, and reconciliation, Pharmacy First expanded its interests with the introduction of Third Party Station, a Pharmacy Services Administrative Organization (PSAO). Third Party Station is the only independent PSAO in the market. With the addition of Third Party Station, Pharmacy First offers valuable services including third-party-contract management and reconciliation with recovery, in addition to adherence services along with several other programs, all designed with the purpose of keeping independent pharmacies competitive in the marketplace.

Base all actions with
openness, honesty and integrity

Employ a strong work ethic to empower the pharmacies we serve

Continuously nurture relationships with pharmacies

Always strive to do the right thing

Constantly grow
and develop to meet the needs of our pharmacies

Mission

Provide high quality service and products to our pharmacy members and affiliates to ensure they remain competitive in the marketplace and are equipped to provide the most value to their customers.

 

Provide
services of the highest quality

Support
our pharmacies and
affiliates with a product suite that helps to remain competitive

Serve
pharmacies with progressive network services

What We Do

Servicing over 2,300 independent pharmacies, Pharmacy First is a solutions resource as well as an informational hub. In addition to our contracting and credentialing services, offered through our PSAO, we offer additional solutions through our Business Center and Performance Center to help meet your business needs.

 

As an independent pharmacy owner, we understand that you are not only concerned with the health of your patients, but you are also concerned with running a successful business. As your PSAO, Pharmacy First is here to help.

We know our pharmacies. We offer great interactions with our clients because we begin with the wants and needs of the pharmacy. We are on the forefront of understanding industry issues. When problems and concerns arise, we promptly respond to our pharmacies about the issue at hand. We always strive for a high-quality customer service experience, because we know the pharmacy industry has a high level of standards. Not only do we provide pharmacy services including contracting, credentialing, reconciliation and support with enrollment, we also streamline two areas fully focused on individual success for independent pharmacies through our Business and Performance Centers.

Contracting

Customer Service

Credentialing

MAC Appeals

Communications

Contracting

  • 100% of contracts enhanced
  • Access to thousands of health plans
  • MAC Appeal Management

Customer Service

  • Live customer service
  • Enthusiastic and compassionate
  • Equipped to help pharmacies with a variety of topics
  • PBM liaison

Credentialing

  • Automatic OIG/SAM Exclusion checks
  • Reminders for license renewals
  • Access to electronic documents
  • HIPAA Training
  • Fraud, Waste & Abuse Training
  • Quality Assurance

MAC Appeals

  • Streamlined process
  • Automatic follow up with payers
  • State law advisement to payers

Communications

  • Continuous industry information updates
  • Routine payer notifications

Incorporating a Business Center enables Pharmacy First to recognize and meet the needs of your independent pharmacy. A business center should be functional, as well as provide educational resources. Your PSAO should not only focus on the services provided, but also act as an informational hub for your pharmacy. The business center gives pharmacies the tools needed to run efficiently and with ease. The Business Center and the Performance Center work hand in hand to support the pharmacy. Our flexibility of programs leave room for choice, growth and opportunity for each pharmacy serviced.

 

PF C.A.R.E.S Plus

  • Policy and Procedures for HIPAA, FWA, OSHA, PSE and Pharmacy Operations
  • Automatic OIG/ SAM Exclusion checks
  • Reminders for license renewals
  • Quality Assurance

Value Card Cash Plus

  • Pharmacy control over discounts passed on to patients
  • No out-of-pocket cost
  • No transaction fees

LibraRx- Reconciliation

  • Central Payment and Direct Payment options
  • Claim level reconciliation
  • Recovery to the penny

PromiseRx Complete

  • $4 Generic Discount Program
  • Multiple pricing options available
  • Compete with mass merchandisers

Pharmacy First also offers engagement tools that allow your pharmacy to critique and measure your performance and productivity. In the Performance Center, we offer tools that will help your pharmacy with cash flow, inventory, relationship building and patient retention. These services provide the tools needed for your pharmacy to enhance its commitment to patient care services, medication safety and educational resources.

Through the Performance Center, Pharmacy First provides tools that allow pharmacies to dive deep and critique performance by measuring productivity. Pharmacies can feel confident using these tools to fine-tune business plans in efforts to stay in focus with the ever-changing pharmacy industry. Pharmacy First goes the extra mile by implementing partnerships and developing plans with companies that are top notch in the creation of these measurement tools. Not only do we meet the immediate needs of our pharmacies, we are also always thinking about the long-term goals. Your customer should be your customer for life. Pharmacy First has created the platform to help you every step of the way to not only support your pharmacy, but for you to better support your patients.

 

PF Performance Suite

  • Improve reimbursements and streamline workflow
  • Edits every paid claim to verify the claim information
  • Automatically applies adjusted reimbursement opportunities

EQuIPP

  • Platform for industry metrics
  • Identify patient compliance needs
  • See which plans are reporting star ratings

MTM

  • Partnered with Outcomes and Mirixa
  • Encourages proper procedures on medication usage
  • View and manage cases assigned to your pharmacy

Medication Synchronization

  • Proactive patient centered focus
  • Easier for caregivers and family members to care for those in need
  • Achieve better star ratings and MTM performance

DIR Fee Information and New Legislation

Third Party Station provides all of our members with information regarding the direct and indirect remuneration (DIR) fees and we encourage you to voice your support for this legislation. Your engagement to continue building momentum for this critical issue is important to us as your PSAO.

 

Third Party Station invites you to learn more about the new H.R.1038/S. 413, the Improving Transparency and Accuracy in Medicare Part D Spending Act. This legislation would rein in abusive retroactive DIR fees charged to pharmacies by pharmacy benefit managers (PBMs) in Medicare Part D.

 

Retroactive pharmacy DIRs, often assessed weeks or even months after a prescription has been filled, prevent pharmacies from knowing at the time of dispensing what their true reimbursement will be for that prescription. Such lag time creates an unnecessary burden on pharmacy operations and makes it very difficult to make decisions for the future. Furthermore, the magnitude of these fees often force pharmacies to make tough decisions to cut back on community contributions or to reduce employee hours, or in some cases laying off employees. Such actions have a ripple effect through local economies.

 

This common-sense legislation would bring greater transparency to pharmacy payments by informing pharmacies at the point of sale what their reimbursement will be for clean claim prescriptions and allow for better business planning. Furthermore, it successfully achieves greater transparency while not interfering with the ability of PBMs to ensure improved pharmacy quality by creating incentive-based payment models that reward pharmacies for achieving contractual-based metrics.

 

Moreover, both CMS and MedPAC have raised concerns over the effects DIR has on patients and the Medicare program. CMS noted that DIR affects beneficiary cost sharing, CMS payments to plans and pushes patients into, and through, the coverage gap sooner. Nearly all catastrophic costs are born by Medicare and these costs have more than tripled since 2010. MedPAC, also raised concerns over Medicare Part D DIR in its 2015 report to Congress stating, “MedPAC sees insurers gaming the system to hold premiums down and maximize enrollment.” Accounting for these fees at point of sale protects the integrity of the Medicare program, ensures beneficiaries are not being overcharged for their medications, and can potentially lower overall costs as fewer beneficiaries reach the catastrophic phase.

Customer Service or Units of Service?

Regularly I need to take pause and contemplate the evolution of our pharmacy profession. Recently I experienced a situation in our clinic pharmacy that caused me to question the meaning of units-of-service.
Late in the afternoon this young lady presented to our pharmacy with a couple of prescriptions from the local community hospital emergency room. This particular patient was from another county, so, when she was discharged from the emergency room earlier in the day she thought it would be reasonable to go to one of the familiar chain store pharmacies.

 

Throughout her afternoon she visited 2 of these stores, both times being turned away without her medications because her insurance was not currently active in this county. She was sick, needed medication, so she headed back to the hospital and found her way to our outpatient clinic pharmacy.

 

As expected, after processing the prescriptions, we also received a message that her insurance was inactive. At this point, we took a moment to ask the patient about her living status. She explained that she had just moved into this county and her insurance had not yet been transferred.

 

This sounded like a perfectly reasonable scenario so I asked my technician to make a phone call to the patients insurance and see if anything could be worked out. After a few minutes on the phone, the insurance had granted a one time override to cover the patient until her insurance could be transferred from the prior county to her new county of residence.

 

This was not a big deal for us. The entire process took 10 minutes and did not interfere with our normal workflow. Why had she gone to 2 other pharmacies and no one had offered to help her resolve her insurance situation?

It is my opinion that the pharmacies were just too busy to try and help her. This is certainly not the fault of the hard working pharmacists or technicians. As pharmacists we are all aware of pharmacy-metrics or units-of-service. During any given time frame we have work flow metrics that need to be met. We all have a que of prescriptions that need to be typed, verified, filled and dispensed.

 

Who has the time to help a patient who has just relocated into a new county and is having insurance difficulties? Any effort that takes the pharmacist and the technician away from performing the necessary functions of a well-run pharmacy will lessen the overall productivity and decrease the units-of-service for the day.

 

As a pharmacist in his 30th year of practice, I understand the pressure we face on a daily basis. Workloads are increasing, regulations never end, and it feels like a new medication enters the market place every single day. This is the time we need to remember the first sentence from the Pharmacist’s Oath we took on the day we graduated pharmacy school.

 

I promise to devote myself to a lifetime of service to others through the profession of pharmacy.

 

In July of 2007 the American Association of Colleges of Pharmacy adopted the new Pharmacist’s Oath. Reading through this document, there is mention of the welfare of humanity, optimal patient outcomes, ethical and legal standards, continuing knowledge, and a host of other excellent measures.

 

Nowhere in the Pharmacist’s Oath is there a discussion of units-of-service or pharmacy-metrics. Tomorrow when you go to work, give yourself a moment to pause before walking into the pharmacy. Reflect on what it might look like to practice in a world without metrics. Then, walk in the door and allow yourself the opportunity to be available.

 

http://www.pharmacytimes.com/contributor/steve-leuck-pharmd/2017/02/customer-service-or-units-of-service

 

Have a question? We are here for you!

Contact Us Today

Phone: 800-460-1575

E-mail: info@pharmacyfirst.com

Address: 11880 College Blvd.

Ste. 420

Overland Park, KS 66210

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