Approval: Pharmacist to verify prescription accuracy
5
Check drug inventory
6
Generate invoice details
7
Apply any insurance coverage or discounts
8
Calculate final bill amount
9
Present bill to the patient
10
Receive payment from patient
11
Approval: Cashier to confirm payment received
12
Update pharmacy system with payment data
13
Print receipt for the patient
14
Hand over prescribed medicines to the patient
15
File a copy of the invoice
16
Update accounts receivable if payment is deferred
17
Send payment information to the accounting department for record
18
Send transaction details to the insurance company if covered
19
Provide patient education & counselling about medication if necessary
20
Close the billing process
Receive prescription from patient or physician
This task is responsible for receiving the prescription from either the patient or the physician. It is the first step in the pharmacy billing process and sets the foundation for the rest of the workflow. The desired result is to obtain a valid prescription. Any potential challenges include illegible handwriting or missing information, which can be resolved by reaching out to the patient or physician for clarification. The required resource for this task is a prescription form.
Enter patient details in pharmacy system
This task involves entering the patient's details in the pharmacy system. It helps ensure accurate record-keeping and facilitates efficient billing. The desired result is to have the patient's information successfully inputted into the system. Potential challenges may include incomplete or incorrect information, which can be resolved by double-checking with the patient. The required resource for this task is the patient's personal information.
Add prescription details in pharmacy system
This task involves adding the prescription details in the pharmacy system. It helps ensure accurate record-keeping and facilitates efficient dispensing of medications. The desired result is to have the prescription details successfully inputted into the system. Potential challenges may include missing or incomplete information, which can be resolved by consulting the patient or physician. The required resource for this task is the prescription information.
Approval: Pharmacist to verify prescription accuracy
Will be submitted for approval:
Add prescription details in pharmacy system
Will be submitted
Check drug inventory
This task involves checking the drug inventory to ensure the availability of the prescribed medication. It helps prevent delays in dispensing and billing. The desired result is to confirm the availability of the medication in the pharmacy's inventory. Potential challenges may include stockouts or low stock levels, which can be resolved by contacting the patient or physician for alternative options. The required resource for this task is the drug inventory list.
1
Medication A
2
Medication B
3
Medication C
4
Medication D
5
Medication E
Generate invoice details
This task involves generating the invoice details for the patient. It helps provide transparency in the billing process. The desired result is to have a comprehensive invoice ready for the patient. Potential challenges may include complex billing scenarios, which can be resolved by consulting the pharmacy's billing guidelines. The required resource for this task is the patient's prescription and personal information.
1
Cash
2
Credit Card
3
Insurance
4
Other
Apply any insurance coverage or discounts
This task involves applying any relevant insurance coverage or discounts to the patient's invoice. It helps ensure accurate billing and maximize cost savings for the patient. The desired result is to have the insurance coverage or discounts properly reflected in the invoice. Potential challenges may include navigating complex insurance policies, which can be resolved by consulting the pharmacy's insurance guidelines. The required resource for this task is the patient's insurance information.
Calculate final bill amount
This task involves calculating the final bill amount for the patient. It helps provide an accurate representation of the owed amount. The desired result is to have the final bill amount calculated correctly. Potential challenges may include complex pricing structures or calculations, which can be resolved by referring to the pharmacy's pricing guidelines. The required resource for this task is the invoice details and any applicable insurance information.
Present bill to the patient
This task involves presenting the bill to the patient for verification and confirmation. It helps ensure transparency and allows the patient to clarify any concerns or discrepancies. The desired result is to have the patient review and confirm the bill details. Potential challenges may include unclear explanations or unfamiliar terminology, which can be resolved by providing clear explanations to the patient. The required resource for this task is the patient's invoice and any supporting documentation.
1
Confirmed
2
Needs clarification
3
Disputed
Receive payment from patient
This task involves receiving the payment from the patient for the billed amount. It helps complete the transaction and ensures timely payment. The desired result is to have the patient's payment successfully received. Potential challenges may include payment method issues or unavailability of funds, which can be resolved by offering alternative payment options or requesting payment at a later time. The required resource for this task is the patient's payment.
1
Cash
2
Credit Card
3
Debit Card
4
Mobile Payment
Approval: Cashier to confirm payment received
Will be submitted for approval:
Receive payment from patient
Will be submitted
Update pharmacy system with payment data
This task involves updating the pharmacy system with the payment data received from the patient. It helps maintain accurate records and facilitates future reference. The desired result is to have the payment data successfully recorded in the pharmacy system. Potential challenges may include input errors or system glitches, which can be resolved by double-checking the data and contacting the IT department if needed. The required resource for this task is the patient's payment and the pharmacy system.
Print receipt for the patient
This task involves printing the receipt for the patient as proof of payment. It helps provide documentation for the transaction. The desired result is to have a printed receipt ready for the patient. Potential challenges may include printer malfunctions or paper shortages, which can be resolved by troubleshooting the printer or having a backup printer available. The required resource for this task is a receipt printer.
1
Payment Amount
2
Payment Method
3
Invoice Number
4
Date
Hand over prescribed medicines to the patient
This task involves handing over the prescribed medicines to the patient. It ensures the patient receives the necessary medication for their treatment. The desired result is to have the medicines successfully handed over to the patient. Potential challenges may include medication shortages or accessibility issues, which can be resolved by providing alternative options or ordering the medication if necessary. The required resource for this task is the patient's prescription and the pharmacy's stock of medicines.
1
Medication A
2
Medication B
3
Medication C
4
Medication D
5
Medication E
File a copy of the invoice
This task involves filing a copy of the invoice for record-keeping purposes. It helps ensure documentation is readily available for future reference or auditing purposes. The desired result is to have a copy of the invoice filed and organized appropriately. Potential challenges may include misplacement or improper labeling, which can be resolved by following a standardized filing system. The required resource for this task is a file storage system.
Update accounts receivable if payment is deferred
This task involves updating the accounts receivable if the payment is deferred or if the patient has set up a payment plan. It helps maintain accurate financial records and tracks outstanding balances. The desired result is to have the accounts receivable updated accordingly. Potential challenges may include missed or delayed payments, which can be resolved by contacting the patient for payment reminders or renegotiating the payment plan. The required resource for this task is the patient's payment information.
1
Monthly installments
2
Bi-weekly installments
3
Quarterly installments
4
Other
Send payment information to the accounting department for record
Send transaction details to the insurance company if covered
Provide patient education & counselling about medication if necessary
