Learn how to dispense at-home COVID tests for covered patients with no copay. And if you are already using this strategy, learn some boosting tips.
You Need To Dispense At-Home COVID Tests
The ability to dispense these tests and be paid for them is a massive opportunity for all pharmacy owners.
The Details
Most patients on qualified health plans will be able to get eight free at-home COVID tests every 30 days for each individual covered person on the insurance. You should dispense all eight at-home COVID tests at the same time.
When it comes to billing these, you bill them like any other prescription you fill. Just bill it to your patient’s PBM, put in the NDC you are using, set it as a 30-day supply, and then it will go through with a $0 copay.
This works for Medicaid, commercial insurance, and Medicare patients, so everybody’s covered if it’s on a qualified health plan. Some insurances are not letting claims process through on the pharmacy side, and that’s ok. Just fill for the patients that you can.
What are the Requirements?
To clarify, you do not need a prescription to dispense and bill for these at-home COVID tests. However, you need a patient to attest or sign that they are requesting these tests for personal use.
The easiest way to get the attestation is to have a form with all necessary fields for patient demographic data that you need with a sentence on it that explains the request. Here’s a sample: ‘By completing this form, I am requesting eight at-home COVID tests to be billed to my insurance for myself or other family members I represent.’
You want to ensure that you document the attestation every time you dispense the at-home COVID tests for a patient.
Do not just autofill all these at-home tests and ship them out if the patients do not want them. I have found that most patients do want them but are unaware they can get them for free
The Numbers
When you dispense these tests, you’ll get anywhere from $40 to $80 in profit, depending on the total reimbursement and how much you pay for the tests. There were some great prices from RxRise.com ($5 per test for FlowFlex) or working with Jessica at PromoSuns ($2.25 per test for iHealth).
Many pharmacies are dispensing thousands of these tests to their patients. Giving your community access to these tests will help reduce uncertainty about what may be causing their symptoms. People don’t want to needlessly isolate themselves and miss work and life events. By having tests at home that are affordable and refillable every 30 days, patients can know if they are positive or negative.
There is an easy strategy you could implement by DiversifyRx. Luke, a pharmacy owner, informed that he made an additional $5,000 in only 7 days after implementing this strategy. If you have not joined their newsletter, ensure you do so you can be ahead on these strategies and get even more value! Join the newsletter here.
We think this is a significant opportunity for pharmacies that may not last forever. Some strategies are short-lived but can be highly profitable if you are the one who takes advantage of it.
Additional Boosting Strategies to Use
For those of you that are already doing this strategy, here are some more helpful tips.
At DiversifyRx’s most recent Drinks, Desserts, and Drugs (DDD) event at NCPA, they stood with a group of pharmacy owners and exchanged their best practices for dispensing at-home COVID tests.
Here is a basic summary of all the best practices from people there.
Maximize Offsite Flu Clinics
My pharmacy does several offsite flu clinics each fall. When you communicate with the employer to have people sign up for a vaccine, have them simultaneously sign up for the at-home COVID tests. You can bring the tests with you when you do the clinic. Don’t forget to have them sign up for their families too.
Leverage Local Employers
Send your signup sheet to local employers or schools to encourage them to have at-home COVID tests on hand for the upcoming season. Tell them you can dispense 8 free tests per 30 days for them and their families with no copay for most insurance plans. You can streamline the whole process, fill for multiple patients and make one delivery. I thought that was a great idea.
Make sure you’re taking care of the whole household, even the kids away at college. Their parents can pick up the tests from you and send them in their next care package.
Article originally from DiversifyRx here.
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