Transcript for "Move the Needle: How to Maximize Your Pharmacy's Flu Shot Revenue": Welcome to today's Thanks, Beth. Hosted by Enliven Health. Our webinar title is move the needle, how to maximize your pharmacy's flu shot revenue. Thank you for joining us today. Before we get started, I'd like to highlight just a few highlight housekeeping items. Please type your questions in the q and a tab to ask questions throughout the presentation. We'll be sure to answer your questions during the dedicated q and a session towards the end of our time together. We are recording today's webinar and the recording will be emailed to all those who registered for this event. And now I'm delighted to introduce today's presenters. Jason Osterley is the head of pharmacy transformation at Enlivant Health, where he's focused on delivering innovative clinical based technology solutions that help mobilize pharmacists as care providers and practice at the top of their license. Jason received his doctor of pharmacy degree from Butler University and his master of science in legal studies from Cornell Law School. He's held a variety of roles across the spectrum of community pharmacy, and throughout his career, his state centered on the aim to expand the scope of pharmacy practice, improve health care quality performance, and ensure pharmacists receive equitable payment for clinical services and improving patient outcomes. Our special guest today is joining us, from Northport Pharmacy. Rob Colburn graduated from Sanford University in Birmingham, Alabama in 1984. He started working at Northport Pharmacy in 1987 and became owner of the pharmacy in 1990. Past president of the Alabama Pharmacy Association and the Alabama State Board of Pharmacy, Rob has had a pharmacy based immunization program at Northport Pharmacy since 1998, and he's been the customer of Enliven Health Medbill and its and its previous iterations for the past 25 years. His wife, Jennifer, manages the gift gallery at Northport Pharmacy, and together, they have 2 children and one grandchild. And last but certainly not least, joining us today, we have Carter Tatum. Carter's the solution sales and strategy manager for financial solutions at Enlivant Health, where he leads his team to help community pharmacies get as much value as possible from front our financial solutions. Carter's been working for over 4 years to drive growth and success for independent pharmacies and has worked with over a 1000 community pharmacies to help them understand the power of their data and analytics in order to help them grow their business. And without further delay, I'll hand it over to you, Jason. Thanks, Nikki. As we get started here, I'm gonna briefly talk through the agenda. If we could see the the next slide. Alright. Are we I'm sorry. Oh, there's the video. Thank you, Ryan. Alright. Here we go. So we're gonna briefly talk through, about Enliven Health. Just for y'all who might not know too much about our company, we'd like to give you a very brief overview. We're gonna highlight Rob, let him talk a little bit about his, his Northport Pharmacy. I'm gonna share just a little little preview of what's coming this fall, some of the changes, regarding, the vaccinations that are available and the recommendations that are, set forth. We're gonna go into some best practices for flu shot programs. We're gonna hear from from Rob in each one of these sections. We're gonna have some dialogue between Rob and Carter on each of these questions, best practices, optimizing clinical service reimbursements, streamlining your vaccination the vaccination process, increasing patient outreach and education. We're gonna talk briefly about upcoming webinars that might be helpful to you, and we're gonna end the last 10 minutes or so, like Vicky mentioned, with live q and a. So please get your questions in. Next slide. I'm gonna, briefly talk about so Enliven Health's mission is to be the innovation epicenter where health and care united the pharmacy. We're dedicated to transforming pharmacies by providing them with digital capabilities to help optimize population health, deliver exceptional patient care, and cultivate sustainable growth. Also, we advocate for a world where pharmacy teams stand at the forefront of health care, empowering them to practice at the top of their license and aiding them with their commitment to patient care collaboration and continuous learning. Alright. Next slide. With that said, I'm gonna hand it off to Rob here to give us a little brief highlight on his Northpointe Pharmacy. Well well, good good morning, good afternoon, wherever your time zone is. This it's good to be with you, and, I was just really humbled by the fact that, these guys asked me to be a part of this and, kinda share some of the experiences we have, here at Northport Pharmacy. And as Nikki said earlier, I've been involved in a, you know, pharmacy based immunization since early early on and, was actually involved with the Alabama Pharmacy Association, whom we were, not necessarily fighting with the doctors, but, fighting for the opportunity to help them, help the people in our community and to get to more people hopefully through immunizations that may that that that need that. And, you know, even now, our community is underserved, with vaccinations, and and we I'm always trying to look and figure ways out on how to get to those people. I came in this morning before I logged on. I've made about 8 phone calls all already, kind of letting people know about when I expected my flu vaccines, and let's go ahead and start planning clinics and things. And, you know, we go all the way from the city of Northport to assisted living facilities to, service companies, and, we just we just look for anywhere and everywhere. And it's even I'll go I'll go somewhere if it's just a couple of folks just to make sure these folks get vaccinated. You know? So out running around giving shots. I'll I'll stop by and give a couple more. It doesn't matter. So but, but, yeah, we've we've been doing that. And, you know, just with the phone calls I made this morning, it's it's probably, that says it's gonna mean about, you know, 350 to 400 vaccines just out of those few phone calls I made this morning. So, you know, that's just away from the pharmacy and not just what we do in the pharmacy. And, so, and we we're we're staffed to do that. We try to do our billing and just put everything, you know, in the workflow and, take care of it as they come in so we don't tend to get behind. Because if I walk in, I've already given about a 100 vaccines that day, then I've got several several to bill, and I've got a technician that's good at billing. So, we've we've got everybody trained, and so this this coming up, you know, that that time of the year, we're we're we're in overdrive just to get people vaccinated. So Well, thank thanks, Rob, for all you do. You're a community pillar in helping people prevent, illness. So thanks for all that you do. Thank you. Alright. Let's move forward to the next slide. I'm giving you a brief update on what's happening, what's new with flu, but also what's new with the other respiratory vaccines. So let's go to the flu slide. Flu is kind of a I don't wanna call it the Super Bowl pharmacy, but it's definitely a busy season for you all. And, our goal is to provide some timely and relevant information in preparation for the upcoming flu season. So some of the important details that came out about this season, we're switching back to a trivalent vaccine versus the quadrivalent that we had last year. And the reason was, the FDA recommended that it's no longer needed to have the additional b, Yamagata flu virus protection. So they they removed that part, since it hasn't been circulating since March of 2020. So you're gonna see, the protection from the trivalent, equivalent to that of the quadrivalent, expected to be similar. On top of that, the CDC now recommends everyone 6 months of age and older with rare exceptions receive the updated 2024, 2025 flu vaccine. As a reminder, September October are the best months for for most people to get vaccinated. It can go beyond October, but it's not recommended, to happen in July August for most people. Now on the respiratory vaccine side, we'll go to the next, slide. We've got COVID 19 RSV and pneumococcal vaccine opportunities happen in concert with flu. Probably don't wanna stick people 4 times while they're in, but, you know, you got two arms. Right? So right and left. Maybe a couple visits this fall to, to get fully vaccinated. The FDA, has, related related some information regarding COVID 19, meaning Moderna, Novavax, and Pfizer formulations will be available later this fall. On the ACIP recommendation front, the CDC director, adopted the ACIP recommendations for this season and is recommending, vaccines in all all patients aged 6 months and older. That information came out late in June. On the RSV front, there's been another new RSV vaccine that has been approved in Revcia, that was approved, in late May by by Moderna. And some of the recommendations on the RSV front, CDC recommends everyone that's 75 and older receive a single dose. Also, folks that are 60 to 74 who are at increased risk of severe RSV, should also receive a single dose of the vaccine. On the pneumococcal front, FDA approved another, pneumococcal conjugate vaccine, PCE 21, capax Capaxib. Sorry. That was, approved on, June 17th, and that the CDC recommends that that's an option for adults aged 19 and over, who already would have qualified or, for a recommendation to receive a dose in the pneumococcal conjugate vaccine, based on, their predisposure. Alright. Let's move on to the next slide. Next, we're gonna start start talking about best practices for flu shot programs this season, and let's go into this slide here. Briefly, I want to talk about everybody's at a different place on their journey. Rob's been doing this for for many, many years. There might be folks that have not started a flu shot program yet, so it's never too late. Now's the time to get in the game because we know that clinical revenue from from vaccinations is not subject to the declining reimbursement rate and DIR fees like like our prescription side of the business. So growing your clinical services is a very healthy thing. Our goal is to help you progress from from no services all the way to practicing at the top of your license where you're offering all the vaccines you can under scope of practice in your state, and you're billing for all the services, including expanded services beyond vaccines like test and treat and other services that really are valuable and helpful to your community. It doesn't happen overnight, but our goal is to help people progress to the next step and continue to build their practice, adding and optimizing vaccines and other services as you go, and that's how technology can help too. As as you go up the progression, your dependence and reliance on technology becomes more important because technology takes those manual tasks and helps drive streamline workflows through automating some of those manual pieces. Next slide. With that said, I'm gonna kick our first panelist question over to Carter for Carter and Rob to have a conversation. Carter, you're up. Yeah. Thank you so much, Jason. And I really love the visual you just showed, really kind of working through and seeing that service progression, all the different areas of opportunity that that's available to pharmacies and how it's, you know, not only grown so far, but going to continue to grow. And as we start off with our questions today, Rob, you you I think as as well as a lot of people on this call recognize that as we approach the fall season, the demand for vaccines is expected to rise significantly. You know, many, not only health organizations, but also pharmacies are preparing to meet this increased demand, and it truly is a very crucial time for strategic growth in this opportunity. So with that in mind, Rob, I'd love to ask you, how do you plan to grow your vaccine business this fall as we quickly and rapidly approach the fall season? Well, you know, as I as I said earlier, you know, one of the things I did, when I got here this morning, I had already, talked with the people that'll be supplying me with my my vaccine, and, I made a phone call just to make sure that, that everything, the expected delivery date was still on board. And, and so I started making phone calls this morning. You know, I'm I'm I'm looking for every the way I plan to grow it hopefully is to just find other people out there that I haven't talked with in the past. Maybe maybe get my my foot in the door with somewhere where somebody else is doing the doing the vaccine and get there ahead of them or something that you know, just kinda, you know, just jump out there and just just be real active right now, in the community, talk to people, talk to business leaders and other people and, you know, small businesses, manufacturing, and just, hey. You know, vaccines plan on gonna be here the last of August, and, let's let's let's start something in September and get you on the books and so that we can get your folks vaccinated and get them going. So, we we we just it's a constant, field effort to get out there just to find to find those that, you you may have missed or haven't talked to before or just an opportunity. Yeah. I just I just use anytime I'm talking with somebody, you know, an exchange club meeting or anything like that, Talk to other business leaders. They'll they'll they'll hopefully can give you an inroad to maybe different businesses that you hadn't spoken to or thought of before. So, you know, it's just it's, you know, one thing before. So, you know, it's just it's, you know, one thing I ran across last year, I called up a real estate office and just said, Hey, your your folks are the community all the time. And, I said, There's you got every opportunity to get a flu bug if you hadn't been vaccinated. And they said, oh, well, you're right. And so I went over and I gave 35 vaccines in that one office. And so, other real estate offices. So that's that's the way I continually every year try to grow my my business is just staying active in the community and just talking about it. Yeah. I really love what you said about getting ahead of them. Right? We know that right now and and as we move into the the fall season and the vaccines become a very pertinent part of the business, you know, setting yourself up for success now, I think, is really gonna be key to having that successful season coming up. I mean, you also mentioned, like, a keyword as well at the beginning, but, also, again, is community. Right? Right. I mean, not only the patient community around you, but, also, the pharmacy community or even expanding outside of that, like you said, looking at other communities like real estate agents or, you know, maybe there's certain communities in the, you know, in your area that are untapped. Being able to identify those communities, really hone in on them, and getting ahead of the curve and being proactive is, you know, an approach that I think is fantastic to highlight. I'm really glad you mentioned that. Thank you so much for your insights, Rob. And Jason, I'll pass it back over for you for the next slide. Alright. Thanks, Carter. Alright. So we've developed this, you know, nice slide here with 8 wins to 8 ways to win this flu season. This is just a kind of a collection of tips and tricks. Starts with scheduling in advance, right, by by managing appointments and getting folks in, based on their schedule that aligns with your pharmacist schedule or your your staff schedule is really important. And next one, you can make it easy. Right? You can print a QR code that allows people to schedule on the fly. You could put that on bag stuffers. You can alert patients through outreach. In the next bucket, we've got spread the word. Right? You can create targeted SMS text message campaigns. You can identify within your patient population who hasn't gotten their flu shot yet or who's due for a pneumococcal or Shingrix or whatnot and send them a campaign message that lets them schedule an appointment slot on the fly. You can plan ahead by by scheduling your, what days are you available each week, what weeks of the month are you available, that you've got staffing available for vaccination, and you can schedule ahead by getting getting those appointment slots out there weeks months in advance so folks have more opportunities to schedule according to their, their schedule, but also that fits with your availability. Rob mentioned off-site clinics. He's doing an amazing job working with he mentioned the the real estate business, and that led to other opportunities opportunities on that front, that's amazing. Get out in your community. Explore how you can help fill those gaps. Employers are looking for help. If you could make it easy for them and turnkey, you know, they're gonna have less people out sick, you know, from work if you if they're protected from flu vaccine this fall. Jason, if I if I if I can just no. Excuse me. I just one thing I I just wanna add to that. When you're talking to employers, they they they really seem, appreciative because, you know, you may have their employees maybe plan on going by and getting a flu shot, you know, after work or something that, you know, rarely before work because it's kind of early, but usually after work or something. But, you know, life is what happens after you leave work, or after you leave the office or something. Things happen and just it it puts it all for a while and, you know, who knows? That may be an important time. But if you can go to them and save them an opportunity to have it have to get out and go, you know, make a special trip to get a vaccine. The employees really appreciate it, and employees do too. Very good point, Rob. It's all about convenience. The easier it is, to get preventative care, the bet the better it's gonna work. Also, leveraging technology to batch print your vaccine administration records. This can be a much more automated experience by collecting information from folks electronically and and in a more personal way and then automating, the the printing of those documents as well. Go online. Right? Leverage an appointment scheduler. We've got a, here at in Limon Health, we've got an amazing scheduling process that helps, again, you know, you define your availability and align that with with the customer's convenience and availability. And doing that online through your website or promoting it through social media, that that can be a great way to reach a large number of people in your community with little effort. And then finally, we already mentioned employer, but employer clinics, I think that's a really important point where you can capture a whole office or a whole, shop full of people in one visit. Right? And such a highly valuable service to an employer because it does promote the health and wellness of their of their employee base. Alright next slide. Alright now we're going to dig into optimizing clinical work flows and reimbursements. I have a couple content slides here and then we'll kick it back to to Carter and Rob. So not a ton has happened on the federal front from a scope of practice perspective, but a lot is happening across the states. We're seeing, you know, we just got through, you know, pandemics in our rearview mirror. We had the luxury of the prep act during the pandemic that opened up, you know, 3 plus through age 3 and above for all ACIP recommended vaccines. We had the, you know, kind of the, reduction in, you know, the PrEP app PrEP Act and public health emergency went away, but we've seen a lot of states jump on board and pass vaccine authority expansions permanently in their state legislation. 2023 was a really busy year. We just wanna give you a snapshot. 55 bills across 32 states passed that expanded scope of practice, and that's continuing in 2024. I think we're even gonna see, a lift in that, even more than even more bills in 2024 than we saw in 2023. So you can see vaccine expansion, point of care testing, test and treat kinda goes right along with flu season. Right? Because you're gonna have some folks that are you're preventing flu and you're gonna have others if you are in a state where you can do test and treat, where you can, you know, test with a positive test, you can provide the the treatment for strep, flu, COVID right there on the spot, and what a convenient alternative, but we just wanted to bring this up because we're continuing to see state progress in provider status recognition, scope of practice expansion, and payment recognition as well that comes along with provider status. We continue to see this trend improving, and the the ages and types of vaccines expand across the states. Next slide. We wanted to talk to you about a sample transformation workflow. What does this look like? How can technology help expedite and remove those manual tasks and drive a more seamless automated clinical workflow? It starts with patient identification. Who are your candidates who hasn't had their flu shot, who might have gotten their first shot at Shingrix, but not the second one? When your when your folks come in for flu shot, who hasn't gotten their pneumococcal yet? These are all great opportunities especially with the new RSV vaccine that has come to life since last year. You can send out promotional messages as I mentioned on the 8 ways to win, but sending out a quick and easy message to these these folks that you identify and allowing them to schedule an appointment on the fly is saves so much time and allows you to fill all your appointment slots in an efficient manner. You need to be able to manage your work, right, so we've got work queue management. It allows you to see where your high priority tasks are, what you need to follow-up on. Importantly, as we provide more robust clinical service, it's important to document what we're doing. If we didn't document it, you know, we learned this in pharmacy school. It didn't happen. And, also, it's important to protect payment by having the appropriate documentation in place. We can help you streamline your MTM, your MTM delivery, Also, automated reporting to vaccine registries. That's an extra manual task that can bog down the overall workflow. Why not make that automated? And, importantly, why we're here talking today is getting paid through medical billing for fee for service professional services. That at the end of the day, we want to help our communities, but we can only do it for so long without getting paid. Getting getting equitable payment is what makes us all scalable. In the same platform, we can help you get paid with from value based payer programs as well. So hopefully that helps you understand, how Enlivant Health can help streamline the end to end clinical delivery process. Next slide. With that said, just gonna highlight what can happen before, during, and after the appointment, and I'm gonna pass it right off to Carter. So before the appointment, the automated scheduling and electronic form intake capture as much information from the patient as you can to populate the VAR document to get you know, provide the vaccine information statement ahead of time. During the appointment, you still have to actually go through the process of, we can't automate sticking their arm. Right? But you still, the electronic clinical documentation process can be streamlined so that as you're providing that vaccination experience, you can be documenting all the details you need. After the appointment, that's when medical billing and claims reconciliation can ensure that you're financially getting paid what you should for doing this service. Alright. Next slide. I'm gonna pass it back to Carter here for the next panelist question. Yeah. Thank you so much again, Jason. You know, that extra insight is really to help us understand, I think, for not only myself, but everyone attending kind of where we're at and also, again, where we're trending towards and where we need to be setting ourselves up for success. But for this question in particular, you know, over the years, the role that pharmacies have played in administering vaccines has grown tremendously. Obviously, during COVID, the door was opened up, and we saw a ton of success from the pharmacy side, of that opportunity. And many pharmacies, while exploring this opportunity, have developed, innovative strategies to really help enhance the efficiency and the effectiveness of these programs, which really is important and key when having these, implemented into your pharmacies, making sure that we're being efficient and making sure that we're taking all the right steps to work smarter, not harder. So we are getting paid, you know, not only the the best amount, but also in a timely manner. So with that being said, to gain some insights as we continue through this conversation, you know, I'd like to ask Rob, what have you implemented over the years to help drive this efficiency in your pharmacy's vaccination program? Well, as I alluded to a little earlier, you know, during during the peak aspect of the season, the peak part of the season, one of the things we do is just we we we get everybody and we get everybody in the pharmacy involved. You know, whether it's just obtaining information that we weren't able to obtain maybe online or whatever, through the scheduling process. And we we we still do the scheduling process, but at peak season, we found come to find out, oh, man. There's so many more people who want vaccines. It's just not yeah. I mean, that just walk in the door. I mean, when you when you have them sitting in chairs or standing up waiting to get a vaccine, that's, schedule out the out the window. If you don't staff properly, So that's the thing that we've tried to do is make sure that all of our pharmacists are are, you know, are immunizers. We have trained technicians that are immunizers. And so as we do that, it it creates several opportunities at at one particular time if you have several people come in that we can we can everybody can get a vaccine. And hopefully we can take care of everybody at one time. If, if there's more that comes in and what I can handle at one time, then, you know, I've I've I've that that means a lot to me because that means, hopefully, I'm doing something right, and I'm being recognized as a good immunizer. So but those are the things I've done is just to as we've gotten busier with vaccines, just to make sure that we're scheduling and we're staffing appropriately for those for those times. Yeah, I think you hit the nail on the head there. Truly, whatever pharmacy is diving into the world of not only vaccines, but many other medical billing opportunities. I think the team effort approach is gonna be a large key to making sure that you're tackling the effort. Right? I like to always say having a champion in your pharmacy, whether it's one person or a couple people that are there that truly understand the process and can speak to that process and be able to know how to, you know, efficiently go through those workflows. It is truly gonna be how some of these pharmacies like yourself are gonna see such fantastic success. So you mentioning that team effort and having that capability, is something that I I really love that you've been able to implement into your pharmacy. And I think as we go on to this next slide here in just a moment, we're gonna see why that's so important. If you wanna go ahead and, click over to the next slide, we can see here some of the numbers. Anyone who knows me or has seen me on these webinars knows I'm a big data guy. I like the numbers. It takes out all of the fluff, it takes out, you know, all of the, your extra outside factors. It really just shows us truly where are we sitting at and what are we seeing. Right? We know that year over year, looking at 2022 or sorry, 2023 compared to 2024, for any pharmacy, reimbursements are down, or that's profits, revenues, margins, etcetera. It's not been awesome. Just to put it plainly, I think almost anyone who's on this call would not be surprised by at least the top section of this slide here with these numbers seeing that there has been a pretty significant decrease in profit. But, you know, across the board, whatever number you look at, it hasn't been very pretty for the the pharmacies we've been working with. But I like to also highlight the light at the end of the tunnel, knowing there are other opportunities out there that are available, not only to pharmacies like Rob, but to really all the independent pharmacies in the, in the United States that there are areas of your business that can be very successful. And when focused on it appropriately, just like how we're talking about how Rob's doing today, can be a significant profit or revenue source for your business so you continue to have a healthy pharmacy to not only serve a community, but also grow your business so you can continue to work with your community and continue to provide the services that you wanna be able to provide. So seeing these numbers, and I'll be moving on to our next question here. I wanna really dive in and focus on the financial side to these vaccines and focus on, you know, really, after all this work has been done, what we're able to capture. So I'm gonna quickly jump over to this next slide. And, Rob, as if when we talk through a large chunk of this webinar today, it's really important that we recognize that managing the financial aspect of administering these vaccines can at sometimes become complex and challenging. There's a lot of ins and outs, which is why it's really important to have a service that can help you make sure that you are efficient in all of the operations that you are running for these vaccines. And many pharmacists have navigated through these various hurdles, and done a lot of effort to optimize their operations when working through these. Reflecting on your experience so far, Rob, if you've as you've gone through these journeys with these vaccines, I'd love to know, you know, as it comes to the financial side of administering the vaccines, what do you wish you would have learned sooner as you had began your process back in the day? Well, I'll I'll tell you what what I'll tell you a story that caught my attention real quick. And, you know, when you're filling prescriptions out there on the plot and then and running everything and these all this stuff goes through, it adjudicates, and and you're thinking, well, I'm getting paid. You know? I'm getting paid. You know? But then I have 1 year when I was having to do my redo my, my Medicare registration and and and, you know, make the necessary changes that that occurred. And I think that happens about every 3 years. But, anyway, I'd sent everything in, and then, supposedly, I got an email saying that they didn't get something. And so this was I I sent it to them, and, it was it's my liability insurance policy. Just something one little front page sheet, and then and I sent it. I emailed that to them. And, so in another, they just didn't get it or didn't include it in time. And so here I am going through, and we're in the height of flu season. And I'm I'm I'm doing all these vaccines and billing all these vaccines, and then I go back and it I looked at my med my med bill dashboard, and all of a sudden, I've got all of these. I just really hadn't paid that much attention to it until about 6 months down the road. Bad to say, it was about that 6 months down the road, and I looked back and all these vaccines I haven't been paid for. And it's like, oh, man. So I called the folks at Med Bill, and they told me where where I needed to go and what needed to be done. And so I called Medicare, and they were they apologized because they they understood that I'd sent everything that I needed. It just didn't get in in a timely manner. And then I for a reason, I for some reason, until I called their hand, you know, brought it to their attention, then I didn't get back was able to start billing. And they said, we'll get you hooked back up. Just refile all your claims. So then I went back to Medbills, and Medbills said, we got you. We got you covered. So don't just always assume you're getting paid. Stay on top of it. That's the one that one of the good things about your Med Bill. You look at it every day and look and see where you are. And, and if, you know, I I don't do it quite that often. I look at it right now. I look at it about once a week. If there's a question, there's an issue, something I may have not gotten paid on, You know, when you're doing it at the at when you're doing it out front at the, you know, at the point of sale, you're assuming that you're you're getting paid because everything looks good. It looks like just any other third party claim. But then somewhere along the way, they they may need a little extra quote narrative or something, and you have to go in and put that narrative in there just to make sure that has to that may you know. So those are the things I wish I had learned to look at earlier quicker so that we would have I would have been paid in probably a little more timely manner. But now, I don't have to worry about that because, through Med Bill, these guys help. And if there's a question that you have, is it well, what do I need to do? I don't understand. They are they have really been great as far as, giving me insight and giving me a direction, giving me a path to, whether it's making a change or calling Medicare and getting those changes made so that I can get get paid for something I didn't. For some reason for some reason or another, it was, it was kicked out. So but, yeah, the the biggest thing I wish I'd learned sooner was to pay more attention to med bill. Yeah. I think it cannot be emphasized enough that it is so critically important to track your claims. Yeah. At the end of the day, we're going through all these, you know, efforts, initiatives. You know, we're spending the money upfront to acquire, you know, all the materials needed to, you know, have ourselves set up to build these claims. But at the end of the day, if, you know, like you just mentioned, if there was one little hiccup or or the the payer missed one little thing or something wasn't checked just the certain right way, you know, something might get thrown off and be having a service where you can go in and log in and see where all your claims are sitting, see where they're at is so so critical. Because if we do all this inner you know, put in all this energy and effort and really focus this is a a very big key component of our business. At the end of the day, we're not getting paid. That can cause a ton of issues for a business, you know, as you're going through this journey. You know, I I I frequently hear the the phrase thrown around is trust the process, but we need to make sure we have checks in place so we can ensure we are getting paid at the end of the day for all these services that we are rendering. So I I really love this question, Rob, and I'm really glad that you, you know, threw in those insights because I really do think that, as anyone in this call is beginning or going through that medical billing journey, there are some really important callouts to make sure that, you know, not only that you're aware of, but everyone's aware of, as some of these important key, factors do play a role in being successful in this side of the business. With that all being said, Jason, I'll throw it back over to you for a couple more slides here. Alright. Next slide. We're gonna talk about increasing patient outreach and education. Next slide. So in parallel, I mentioned the policy reform is something that's happening rapidly at the state level. We also have a very important consumer demand picture. When I ask you the question why are folks coming to the pharmacy for more services? I mean, we've been doing vaccines for a long time. Right? But, you know, we're expanding into new vaccines, or we're expanding into new services. And the answer at a high level is patients want convenient care closer to home. There's no one more accessible than a patient's local community pharmacy. 90% of the population lives within 5 miles of a pharmacy. In the face of a rising primary care physician shortage, this could be up to almost 50,000, a gap of almost 50,000 primary care physicians by over the next decade. Pharmacists are uniquely positioned to fill some of those gaps for minor care services. Not to mention the high touch model. Right? Pharm patients see their pharmacist many more times than they see their primary care physician. And what happens when someone comes down with, symptoms of the flu on at 5 o'clock on a Friday? Oh, this doesn't apply to all states, but states that have test and treat, a patient can go to their pharmacy and see their pharmacist, receive a test, and in 15 minutes, if the those test results are positive, walk away with the prescription. Are they gonna be able to get into their primary care physician at 5 or 6 on a Friday? Chances are they're they're a week or 2 out on getting an appointment if that. The alternative would be go to urgent care or ER, and those are not cost effective, alternatives. And then finally, convenience. Folks that visit pharmacies for things like vaccine and test and treat, almost 40% of them come to the pharmacy outside of their normal physician's office hours. Not to mention almost 35 percent don't have a primary care physician to start with. So this shows that really patients, want convenient care closer to home and there's no one more uniquely positioned for that for minor care services in their local pharmacy. Next slide. On top of, we've talked about policy reform now and consumer demand, public perception is changing. A couple highly respected organizations McKinsey and Walter Skluer, put out patient based consumer based surveys last year, and these these surveys, the, the McKinsey survey found that consumers of all backgrounds appear to welcome all types of retail pharmacies, taking on broader role that is more than just filling prescriptions. Right? They see pharmacist as a destination for services, And the Walter Skuor study found that 3 out of 5 American health consumers can envision most primary care services being provided at pharmacies, retail clinics, and or pharmacy clinics instead of going to their PCP. Really powers powerful stuff here. The 3 key influencers, policy reform, consumer demand, and public perception are really changing the industry, the landscape for pharmacy in a very positive way. Alright. Next slide. I think we've got another question here for the panelists. Carter, back to you. Yeah. And, you know, we kind of touched this a little bit earlier, but, you know, promoting flu shots, you know, these programs effectively is very imperative for ensuring community health and increasing the vaccination success. Pharmacies play an incredibly vital role in the effort of, you know, the flu shot programs around the country, and the the successful outreach can really make all the difference. You know, Rob, you already mentioned working with some of these communities, and I would love to expand on that and hear what that looks like. So could you share with us how do you get that word out? And, you know, not only how you're getting that word out, but how are you talking to those communities about your pharmacy's flu shot program, and what does that look like for you and your pharmacy? Well, you know, as I as I said, just talking to people in the community. I have a friend of mine who is, who is in HR at a very large manufacturing Mercedes Benz manufacturing plant here in right outside of Tuscaloosa. Now they they have everything in house there, so I I, I'm I'm not able to get into their, you know, 5, 6000 employee, facility to give that many vaccines. So they do have all that internally. But one of the things I did find out after talking with him is he's the HR guy there and several manufacturing facilities around in Tuscaloosa. All these HR guys tend to get together once a quarter or so and just talk about HR stuff, things as what are you doing, what's happening in your in your facility, and all that. And and when I was talking to my friend that was involved in HR, he he says, Rob, he said, you just need to talk to some of these guys, and I I'll get you some names and some phone numbers. And so I'll just start picking up the phone, calling the folks in manufacturing facilities for the app no matter how big they are, but, some of them, like I said, did it internally, but others didn't. And so with that, in mind, you you talk to these HR guys. They talk with each other and, just, like I said, it's, word-of-mouth helps. And then I I had 2 manufacturing facilities, last year. Just picked up the phone and called me and said, hey. I hear you're doing vaccines, and you'll come out to us. And I said, yes, sir. I will. So, but, so that's, you know, that's the way you do it. Just talk. You just gotta talk to people and, when you're in the community. You know, whether it's your chamber, Converse, or or whatever it is, just just talk about it. And, and it's it's amazing that, you know, like I said, I'm I've just gotten phone calls out of the blue. It's been amazing. Yeah. I think what you said there is communication is key in this effort. One thing I've not only heard from you, Rob, but others that we've worked with is that you'd be surprised how well word-of-mouth alone can work. Obviously, we wanna make sure we're expanding and being able to have every single channel of communication open and available to us, which is gonna be very important in being able to have different ways to effectively reach those patients. But the word-of-mouth aspect of just having those conversations is a starting point, whether you are working with HR reps, working with, you know, other areas in the community that you mentioned, you know, just getting that word out, expanding upon that, making sure that people understand and are aware that these opportunities at your pharmacy are available to these patients is going to be so key as we, you know, come up on this this flu season. I think everyone here knows people talk. The age of the Internet is is huge and, you know, Facebook, Instagram, your online social media sources, people like to share, kinda what's going on and where they can go to get these different shots. And being a part of that conversation, just like you've done, Rob, I think is a great way to set yourself up for success. And it's really glad or it's really good to hear that you have been able to really put yourself out there and make yourself someone in your community as a go to place for someone to go to be able to get those vaccinations. Alright. Thanks for that. We're gonna just cover a couple, couple more things here, and then we'll flip back over to the audience for the q and a section here. So a lot of what we've talked about today, you've heard from Rob's personal experience. You've heard from Carter, and some experience that's a little bit broader. But at the end of the day, you need to be able to get paid for the services that you're providing. Clinical service expansion is dependent on equitable reimbursement, and that's where medical billing comes in. Our med bill product automates, streamlines, provides visibility. You know Rob mentioned the the story of being able to track payments. You wish you would have, you know, paid attention to that earlier in that one scenario, but the good news is what would you do if you didn't have a medical billing platform, right, that that allowed you to see, the different statuses of your claims and be able to react when you realize, gosh. I didn't get paid. I need to do something here. So, you know, we we can help you bill for any of the services that you wanna provide. You know, a lot of people, work with us on the the Medicare part b flu shots, but, you know, theoretically, as long as you're functioning within scope of practice and you're, and and, your state Medicaid or or Medicare program allows you to do it, we can help you get paid for any of those CPT or HCPCS codes. We can, you know, we work with commercial payers, Medicaid, Medicaid MCOs, Medicare, private insurance, for any service that, like I said, said, that you're qualified to do, credentialed, and contracted to do, we can be your vehicle for getting paid. I mentioned tracking your billing, detailed claims history. It's really helpful to know, what are those claims that may be outside the 30 to 60 day window that I should have gotten paid for that aren't coming through, I need to follow-up on those because that's all revenue that you're you're missing. Right? The whole goal is to provide services, get revenue in, reassess the impact on your bottom line, and then grow those services. If you're not getting the payment in, you don't have the staffing to grow those services. So it's all all system that works together. We wanna help you optimize reimbursement across the board, all of your vaccine business. Is it is it potentially a vaccine that you've been billing for on the prescription side, but you could get credentialed on the commercial side to get paid through the medical billing channel? Are those payments different? You know, we see trends that, yeah, you you wanna get paid as a provider, not as a dispenser of vaccines. Right? So that doesn't really belong on the pharmacy side. It works in many scenarios. Right? The admin fee is still healthy, but how much further could you go if you're getting paid as a provider? And then finally, you know, manual billing is costly. Who wants to fill out a fill out a 15 100 form? Right? That's that's not what we're trying to do in this in this modern era. So let us automate those things. Let us get the the health plan set up for you that are relevant to your geography and, help you get paid for what you're doing. So I wanted to give a quick plug before we cut over to, the q and a session. We've got another webinar, Med Bill and Your Pharmacy. It's a more guided walk through, That's with you, Carter. Right? You'll be working on that one. It's, Tuesday, July 23rd. Regardless if Carter's leading it, we're gonna have a we're gonna have a highly qualified medical billing expert walk you through, our medical billing platform in a more detailed manner. So today wasn't really the the demo part. This is the, more of the thought leadership message, but please join us on July 23rd at 1 PM EST for a deeper walk through of the actual platform. You can register by clicking on the scrolling banner down below. Hard to miss. So please do register for that info session. Alright. I think we're next slide is questions. So give me just a second here. I need to change my screen view to access the questions. Yeah. And, Jason, as you read through those, I I wanted to quickly throw something out there. And as we start our q and a section, I wanted to kinda remension something that Rob said earlier. Having a good support line can be a very huge game changer for pharmacy as they are they either they are beginning, or have been going through, or really trying to maximize their vaccine efforts. And I'm very proud of our MediBuild support team here at Enlivant Health. And I would encourage anyone that has our MediBuild services, just like Rob said earlier, to reach out. If you have any questions, concerns, need help trying to figure out kinda what's going on with your claims, please feel free to reach out to our, what I like to say, is our great support line. You know, call, email, let us know how we can be of service to you. It's really imperative, I think, for pharmacies that are gonna go into this process that if you do encounter any snags, just like, again, Rob had mentioned a little bit earlier, to use that resource to your advantage. So I just wanna quickly highlight that as we begin our q and a section here. And if I could add just one more thing real quick, something that Jason alluded to a little earlier. Now I really wanna make sure that it's that's that's highlighted. In my area, we had we had, a large group that, Blue Cross Blue Shield of Alabama group, that their vaccines are still going through their their medical insurance. Well, we happen to have a, provider ID for, for DME. And so I called Enliven Health and asked those guys at the in the med bill section and asked them. I said, hey. Is there some way I can bill? If I'm billing meters and billing those these kinds of things too? Is there a way that I can bill these vaccines? And they said, sure. So, I mean, it didn't take them long at all. We got hooked we got hooked up doing that, and so a section of the folks here in in my town that I couldn't serve, now now I'm able to serve them too. And, so they they'll help you get set up with the commercial side just like they do with the Medicare and, and the pharmacy side. And, so but that's that's been a real positive because people I was having to turn away because I just couldn't bill to them. I said, you gotta go to your doctor. I didn't like saying that. I wanted to do it. I want to take care of them right here. So and and Med Bill was really great about getting me set up to bill those people. Yeah. Thanks to that, Rob. That's kind of a a a lead in to our our first question here. Audience question. If we're talking about billing vaccines to medical plans, is a CPA needed in California to bill, and can Enlivant Health Enlivant Health help us in the billing process? First off, yes. We can help you. As Rob just alluded to, billing vaccines is one of our specialties, you know, really all clinical services that fit within scope of practice. You know, we can help folks get started. If you don't have your PTAN, that's a provider transaction access number that's needed to bill Medicare either as a mass immunizer or a pharmacy, We can help you with that. Just let us know. Is a CPA required? I'm not trying to, you know, I'm not trying to put out any legal information on the call today. I I happen to know that, you can do certain vaccines in California without any collaborative practice agreements, for the ACIP recommended vaccines, but I urge you to work with your state pharmacy association on these topics, right, because they're the source of knowledge in your state when it comes to lobbying for scope of practice expansion and, you know, fighting for, these things that actually become law. So they're really well versed, in in what, you know, your current scope of practice and and rules and regulations support. But hands down, we can help you whether it's, getting started with Medicare and and flu shots, whether it's, you know, some state Medicaid programs are really friendly from, billing vaccines at the Medicaid level, through the Medicaid and NCOs, through the medical billing channel. And I I would urge you, if you haven't had the conversation with the high volume commercial plans that are in your ZIP code, for the employers that you work with on a regular basis, you know, start that conversation. If you're not rec credentialed as a provider with the commercial plans, they do obviously pay for vaccines, right, because they pay for vaccines that are administered by the physicians. So why can't we get recognized as providers on that front as as well? May require a little bit more grit and, you know, calling into the provider line of the health plan versus the pharmacy line that you might not be used to, but now is the time to get that journey started. Alright. Next question. How do we medically bill for vaccines? Carter, do you wanna you wanna take that one? I I think there's a couple different workflows, but one kinda primary workflow that's that's helpful for billing vaccines. Yeah. So I'll put this, you know, a very brief overview of what that process looks like. So here in LiveIn Health, the way we set it up is that you're actually able to bill our bin and PCN. And the way that I like to describe is we are taking, English, which is the the pharmacy language, and translating that into the very complex language that is, the medical billing payer language. So you're able to bill directly through your pharmacy management system. The claim will come to the Live and Health medical billing side, which is the clearing house, and then we will package and send that off to the payer. It's a very seamless process. You're able to log in to the portal and see all the claims that are flowing through, but it's a very smooth implementation into your pharmacy workflow and allows you to actually take advantage of those current workflows you workflow and allows you to actually take advantage of those current workflows you have in place through that pharmacy management system that you are using. And as you get implemented, we have a ton of training resources available to you. So if you have any more complex or specific, you know, vaccines or, you know, medical billing, claims that you're trying to bill through, we can help make sure that those are set up appropriately and are flowing accurately to make sure you are getting paid. If you want more additional information, I'm happy to share that with you, and, please feel free to reach out and let us know. We can give you more specific insights into specific claims you're wanting to bill. But that is just a very brief high level overview from the billing perspective side. Great. Thanks, Carter. Next question up. Can you do diabetic shoes through MediBill? Absolutely. And in in a lot of ways, that's where medical billing and pharmacy got started was through DME or durable medical equipment. So it just be aware it does require you have to have the DME POS, pharmacy trans the PTAN number, the appropriate PTAN number for Medicare in order to do to get involved in DME billing, but, absolutely, our platform accommodates, all types of, DME billing, durable medical equipment. Next question. We are able to bill as medical providers for commercial Blue Cross Blue Shield. Are we allowed to bill on the pharmacy side for the vaccine but also on the the vaccine for time spent for the actual vaccine encounter counseling? We can for time spent on point of care testing. Just not sure if it's different for vaccines because I know that doctors would officially bill for both. Carter, you want me to take that, or you wanna take it? I'll let you take a stab at it first. Absolutely. What you're talking about is billing for an office visit or billing for evaluation and management codes. If your Blue Cross Blue Shield contract, allows for you or, has language that supports paying for you, for the actual office visit administration, then I would say, absolutely. You can leverage our medical billing platform, to bill for an office visit. Sometimes there's specific language regarding vaccine admin codes. Although those admin codes might not necessarily be an office visit, you can still bill for those admin codes, CPT codes in our platform to get paid as a provider. So regardless, if your vaccination product is getting reimbursed and paid on the prescription side through, you know, the prescription claim switch, you can still submit your service time through on the medical billing side. It's important that you do have the clinical documentation experience in place, you know, backing up that you delivered this vaccination to this patient and, you know, you know, documenting the experience in a clinical way. Because as soon as you start, you know, getting into the world of medical billing and and and and billing for office visits, and it becomes more important to have a a good documentation trail of the, of the record of the medical record that you've, added to. Anything to add, Carter? No. I think you covered it. But the one thing I would add, which you already really said this was, with these payer specific questions, it's really just gonna come down to the the dependent, it's gonna be dependent upon the contract you have with that payer. So for example, with Blue Cross Blue Shield, if the language is written in where you are available, to have that as something you can build, then, that would be definitely something that we could make sure that we're getting you set up for. Absolutely. I got a question, on on cost and maybe following up, please. There is a get demo button, at the top of your screen here. We would love to follow-up with you directly to talk about those items and and answer any questions that you might have in a more personal manner. So please use that get demo button for for specific, conversations like that. How are you handling, billing MCO plans? I can tell you, it varies by state. Right? Some Medicaid MCO plans have have everything ironed out, and it's a very turnkey process. We set them up, very simply. Like, they they are Medicaid, but they operate like commercial plans. And we work with a number of states, in their state MCO plans and for billing vaccines. They've had a lot of success on that front. Depending on your state, it could vary. Certain states have MCOs that are very geographical in nature and other states have MCOs that are available by patient choice. So I'd say, let us know if you're interested in building your MCO, for vaccines. Make sure you go through the enrollment process with with your MCO. A lot of times, you have to enroll with each individual each individual MCO, but we can definitely help you get those payers set up and get you paid once you complete the enrollment steps. Alright. We are at the top of the hour. Anything any last final words, Rob or Carter, before we cut out? I'll quickly throw something in that that this will answer one other question as well. As you mentioned, Jason, depending on different states and depending on legislation and what's available to you, this process in different, you know, areas of opportunity within medical billing might be available. One of the questions was, does Med Bill work for New York as well? Yes. It does. And with every state, there are gonna be, some different nuances and different legislations, different legislation that has been passed to allow different opportunities for you to bill. But across the board, the the medical billing is available for all states, and is an option for you. But as Jason just alluded to, depending on that state, there can be, different opportunities within MediBill that you have at your disposal. So just wanna end on that note, but, again, really excited as we approach the flu vaccine, you know, quote, unquote Super Bowl, for the pharmacy industry. And we're looking forward to seeing all the great success with all the customers we work with. Rob, anything that you wanna end us off with? Well, just to kinda highlight again what you had to say there, whether you're concerned about it in your jurisdiction or your state or whatever. Folks at Med Bill, they've they've they've been amazing to, any anytime I had a question, can I do this where I am? And, they they quickly can figure that out for you. So, if you've got a question, whether it's in New York, whether it's in California, the, you know, states I've heard. I'm in Alabama. You know, it's, I try not to leave anything uncovered. So anything I can get those guys working on to help me build and pharmacy, they've been great to do so. Great. Thank you all. If we didn't get to your question, rest assured we will follow back up with you. If you do if you wanna zoom in on any of these pieces we covered today, we will provide the links so you can rewatch or share with your with your friends. Rob, thank you so much for joining us. You're a great guest speaker today. Your real life experience is gonna benefit a lot of the audience that was here today. So thank you so much for joining us. Also, Carter, thank you for being a part of this. Your knowledge is is very inspirational. And to all of you, thanks for joining us. We know taking an hour out of your day is really, really a lot to ask for, But we appreciate all the questions and look forward to the opportunity to catch you on the the webinar on the 23rd or a demo direct demo experience if you click that get demo button. So we appreciate you. Thanks for all that you do to help your communities. Stay safe and well during this upcoming flu season. You are a pillar of your community, and we appreciate all you do. Thanks, everyone. Thank you.