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News & Press: WSPA News

Implementing ESSB 5557 - Billings Workgroup Update

Wednesday, March 9, 2016   (0 Comments)
Posted by: Kathleen Goodner
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On February 19, 2016, the Billings Workgroup met to continue its work on creating a Billing Guide and Documentation Guide to help pharmacists implement ESSB 5557.  In 2015, a new law was passed requiring most commercial health plans to include pharmacists in their participating provider network.  Beginning in 2017, pharmacists in different practice settings can bill and be reimbursed for covered medical services that they provide.  
Earlier this year, the WSPA established workgroups to develop educational and training tools to help prepare pharmacists to take advantages of new opportunities as medical providers.  Since billing for medical services is different from billing for dispensing drugs, pharmacists must adapt and learn new processes to succeed.  
Co-chaired by Stacey Olson and Melissa Hull, the Billing Workgroup has met twice this year to focus on developing two draft documents: (1) a Billing Guide which includes billing codes and diagnosis codes that pharmacists may use when billing for medical services provided to patients; and (2) a Documentation Guide to help pharmacists understand how to appropriately document outpatient and office visits services using complexity-based billing rather than time-based billing.  The Billing Workgroup anticipates finishing these two documents in the next two months.
In the next few months, the WSPA will be rolling out new training and education programs.  For more information about the Billing Workgroup, please contact Vergil Cabasco at

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