Workflow Services provides a unified platform that guides pharmacists through patient encounters, captures clinical data, and automatically generates and submits accurate medical billing codes to insurers. The system automates claim processing, tracks reimbursement status, and offers analytics to help pharmacies add clinical services and capture new revenue streams.
Funding
Funding not disclosed
Founders
Product
Problem
Pharmacies often lack integrated tools to manage clinical encounters, generate accurate billing codes, and submit insurance claims, resulting in missed reimbursement opportunities and limited ability to provide expanded healthcare services.
Solution
Workflow Services offers a unified platform that guides pharmacists through patient encounters, captures clinical data, and automatically translates that information into appropriate medical billing codes. An automation engine extracts encounter details, generates claim codes, and submits them directly to insurers, reducing manual effort and claim errors. The system also provides workflow tools for scheduling, documentation, and patient management, enabling pharmacies to add clinical services to their offerings. By handling billing end‑to‑end, the platform creates new revenue streams for pharmacies while supporting payors in reaching community patients and improving health outcomes.
Features
- Integrated patient encounter interface that structures clinical documentation for pharmacy-based services
- Automated billing engine that extracts encounter data, selects correct CPT/HCPCS codes, and submits claims to medical insurers
- Real‑time claim status tracking and reimbursement reporting within the pharmacy dashboard
- Secure, ISO 27001‑certified data handling and storage to meet healthcare compliance requirements
- Role‑based access controls allowing pharmacists and staff to manage workflows without exposing sensitive information
- Analytics module that highlights service utilization, revenue trends, and patient outcome metrics