 FINANCIAL FEBRUARYHaving a good handle on your personal finances is the best head start you can give yourself in business. Do you have a good understanding of personal expenses (whether you use the "b" word or not ... budget)? If so, it will be easier to calculate how much money you actually need to walk away from a job. Pharmacists often ask me: How long will it take to replace my pharmacist salary so I can leave my job? But I think that’s the wrong question. You should first ask yourself: What are my base fixed expenses that I must pay each month? When I put my pen to paper and really looked at my budget, I realized how little I actually needed to cover the basics! I had no idea how much less I could live off of until I wrote it down. That knowledge made my transition to entrepreneurship much less scary. The first year, after I lost my job, I took a $40,000 pay cut! But working for myself set me free. I also made every mistake there is to make on my road to entrepreneurship. That is why I invited Your Financial Pharmacist founder and author of The Seven Figure Pharmacist, Tim Ulbrich, to our February Member Call to talk about "How to Become a Seven Figure Pharmapreneur." I want Pharmapreneur Academy members to avoid the same missteps I made on my journey. Tim will teach us calculations and exercises to help us put our personal finances in order and build our businesses on a healthy financial foundation. I will also SHARE my own experiences with personal finance and how it’s changed my life. My kids are still a bit young to understand money but when we begin talking about it my first lesson to them will be: "You can afford ANYTHING you want, but can’t afford EVERYTHING." - Paula Pant I think that applies to business, too. You can afford to build the business of your dreams. As soon as you are willing to sit down and look at what you’re no longer willing to waste money, time, and energy on. Once you focus, you can redirect those resources into your business. 99491: THE NEW CCM CODE ON THE BLOCKDo you remember the "regular" CCM code 99490? It codes for about 20 minutes of a non-provider clinical staff member visit with a patient enrolled in a chronic care management (aka CCM) program. Code 99490 is for a once monthly non face to face visit with a patient that generally reimburses for about $42. As of January 2019 the Centers for Medicare and Medicaid introduced a new code for CCM: 99491. The "little sister code," 99490, is for 20 minutes of non provider contact with a patient. The new code 99491 is for 30 minutes of “directly involved provider care.” That means it needs to be provided by a qualified healthcare professional instead of clinical staff member. At this point I would not recommend that pharmacists attempt to bill for code 99491 since in most states we do not have qualified health care provider status. The difference in reimbursement, however is quite generous. If you are practicing with a provider who spends a little bit of extra time with the patient in a given month the provider is able to bill for their time using the new higher reimbursing code. Whereas the 99490 code reimburses for about $42 dollars the new one reimburses for between $74 and $84 dollars At 30 minutes versus 20 minutes, code 99491 pays almost double what you would be paid for the 20 minute 99490 visit, thus reflecting the provider’s direct involvement. We expect to see code 99491 being used in place of with 99490 when on a certain month the provider must be more involved. However the 99490 and 99491 codes cannot be used together in the same calendar month. Additionally if you'll refer back to our complex and chronic care management code video you’ll see there's also a “complex code 99487” that codes at an even higher rate for a more complicated patient visit. Code 99487 cannot be used at the same time as a 99491 visit either. CMS wanted to give providers who are more involved in the patient's care a chance at the higher reimbursement. If, for example, the next month it can return to clinical staff member (or pharmacist) they can return to using the 99490 code. Just remember, right now, only ONE of the codes, 99490, 99491 or 99487 may be used per month based on the level of care provided. If you're interested in learning more about chronic care management, get more information and videos like this one delivered straight to your inbox by registering at btpharmacyconsulting.com/newsletter Ready to get your CCM consulting business of the ground? Click here to register for our LATEST webinar the Top 3 Most Successful Consulting Business Models  New! ELEVATE SUMMIT PODCAST Exciting news Pharmapreneurs! Our new podcast featuring interviews from the very first Elevate Pharmacy Virtual Summit has now launched. Not familiar with the Summit? The Summit is a way for pharmacy professionals to earn continuing education hours by listening to or watching interviews with industry experts. You can listen anywhere, like, the comfort of your own home. "We love the virtual summit because it allows all members of our pharmacy team to watch the interviews and get excited about the content." It can be tough for one person to come back from a conference and relay the excitement and information to others We know that not everyone can travel. But now there is a way to share in the experience while learning everything that’s usually only available to conference attendees. The Elevate Pharmacy Summit Podcast Season 1 Interviews about consulting in ambulatory care settings from: ⇢ Amina Abubakar ⇢ Joshua Akers, PharmD, BCACP ⇢ Nicholas Dorich ⇢ Mary Ann Kliethermes ⇢ Sandra Leal ⇢ Ashley Lorenzen PharmD BCPS ⇢ Kate Morton ⇢ Sue Paul ⇢ Michelle Thomas ⇢ DeArcy Vaughan, PharmD, MBA, BCACP, CDE, CTTS Listen to these interviews and get excited for this year’s Elevate Pharmacy Virtual Summit, May 8-12, 2019! You can get your free ticket at ElevatePharmacySummit.comNot a podcast junkie (yet)? Here's how to get on-board:
Keep an eye out for Season 2 to drop around the middle of March.  GxRPh: The Academy's Latest Training Course!
This is a message I received from one of my Pharmapreneur Academy members. I love getting these messages because it reminds me of the rush that comes with new opportunities. As a pharmacist, you may think you’re “stuck” in a certain type of job, but you’re not. I found MTM consulting and it changed my life. Now I’d like to help change yours. If you are interested in learning more about Pharmapreneur Academy, sign up for this Sunday's LIVE webinar! The free, Live training is March 3rd at 4pm CST --->>> CLICK HERE TO GRAB YOUR SEAT 2019 PHARMAPRENEUR WOMEN'S RETREAT AND MASTERMIND"It was a great small group experience that helped me see people in all walks of life trying to achieve a dream. Totally different than what I expected because it wasn't a group of just independent pharmacy owners trying to make ends meet. I did love that it was all women as most groups are mixed. I would love to do this again!" What is a MASTERMIND group? A mastermind group offers a combination of brainstorming, education, peer accountability and support in a group setting to sharpen your business and personal skills. I joined my first mastermind in 2016 with a group of women that saw eye-to-eye. I didn’t come from a family of entrepreneurs, so having other business owners to talk to was a huge benefit. It’s because of that experience that I am hosting my second mastermind retreat for female pharmacists! We will meet in Las Vegas for two days (Sept. 13 & 14, 2019) to help you plan and develop new projects for the year and discuss opportunities for growing your business. If you are interested, read more in the blog post and email me directly to see if you'd be a good fit! THE 3 "LEGS" OF THE PHARMAPRENEUR ACADEMYPersonal development is SO important for the business owner and the business.
SO MUCH SO, I RECENTLY DID AN ENTIRE TRAINING ON PERSONAL AND PROFESSIONAL GOAL SETTING. The Pharmapreneur Academy has some specific recommendations for services to offer. However much of it is business related advice (not clinical) and can translate to many different business models in pharmacy. Most of our members are either implementing consulting services in the community pharmacy setting (health coaching, weight management, genetic testing, etc) or in an ambulatory care setting under a collaborative physician. We now have over 160 members in the Pharmapreneur Academy and many of them started with some of the same questions you probably have right now. We've got members ranging from the brand-new entrepreneur to more advanced business owners who already have a consulting arrangement, but need help refining their model. There are 3 essential "legs" of the Pharmapreneur Academy: the e-Course, the Forums and the Monthly Member Calls.
The February member call is a training with Tim Ulbrich an expert on pharmacist personal finance and author of The Seven Figure Pharmacist ". It can be attended live or accessed via replay in the Academy Forums. The Pharmapreneur Academy is a good fit for pharmacists who are thinking about offering innovative services, but aren't sure exactly where to start. The e-course at the Academy is a comprehensive business coaching program for pharmacists wishing to start offering advanced consulting services. Thanks so much for reading and I'll see you right here again next Month! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.
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Join us on March 3rd for a brand-new course on "How to Build a Genomics Consulting Business". In the GxRPh e-Course you'll learn:
GxRPh is great for pharmacists interested in:
On our free training we'll discuss
Plus, we'll be taking your Questions! Like...
Register now and join live or catch the replay!
About Your Host: Blair Thielemier, Founder & Coach, Pharmapreneur Academy
Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.  The Pharmapreneur Academy is proud to welcome Your Financial Pharmacist co-founder and CEO Tim Ulbrich to Guest-Host our February Member Call! Tim is a clinical professor of pharmacy and program director for the Master's in Health-System Pharmacy Administration at The Ohio State University. After paying off more than $200,000 in non-mortgage debt, Tim is working to empower pharmacists and pharmacy student to take control of their future. He is the founder of the Your Financial Pharmacist blog and co-host of the Your Financial Pharmacist Podcast. Tim and his colleague Tim Church are the authors of the Seven Figure Pharmacist, a read I highly recommend. This month's live call is Tuesday, February 26th at 8pmCST and will focus on becoming "The Seven Figure Pharmapreneur". Live attendees with have a chance to ask myself and Tim questions about how we handle our finances as small business owners. You're going to hear us share personal experiences and what's worked for us throughout our "pharmapreneurial" journeys. CLICK HERE TO PRINT THE WORKSHEET WE'LL USE ON THE CALL These Monthly Member Calls are an exclusive benefit for current Academy members only, if you're not a member JOIN Now at Pharmapreneur Academy.com to get instant access. A few things we'll be covering on the call is:
I've dubbed this month "Financial February" as I think is a fantastic time to reflect on your financial foundation while putting your tax documents together. In this week's Academy Forum thread, I shared my financial goals for this month, which are:
These Monthly Member Calls are an exclusive benefit for current Academy members only, if you're not a member JOIN Now at Pharmapreneur Academy.com to get instant access. I hope to see you on the call! About Your Host: Blair Thielemier, Founder & Coach, Pharmapreneur Academy
Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. What you will learn on this free training :
Register now and get instant access to this free training! About Your Host: Blair Thielemier, Founder & Coach, Pharmapreneur Academy Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.
Today we're discussing the newest CCM Code 99491.
So if you remember the "regular" CCM code 99490, codes for about 20 minutes of a non provider clinical staff member visit with a patient enrolled in a chronic care management aka CCM program. This is a once monthly non face to face visit with a patient that generally reimburses for about $42. As of January 2019 the Centers for Medicare and Medicaid introduced a new code for CCM: 99491. The "little sister" 99490 is for 20 minutes of non provider contact with a patient. The new one 99491 is for 30 minutes of directly involved with the provider's care so it needs to be provided by the qualified health care professional instead of clinical staff member. At this point I would not recommend that pharmacists be able to bill for the 99491 code since in most states we do not have qualified health care provider status. The difference in reimbursement, however is quite generous. If you are practicing with a provider who spends a little bit of extra time with the patient and is much more involved in a home visit in a given month you can use the higher reimbursing code. Whereas the 99490 code reimburses for about $42 dollars the new one reimburses for between $74 and $84 dollars. Almost double what you would be paid for the 20 minute 99490 visit. We expect to see this code being used in conjunction with the 99490 when on a certain month the provider must be more involved. However the 99490 and 99491 codes cannot be used together in the same calendar month. Additionally if you'll refer back to our complex and chronic care management code video you know there's also a complex code 99487 that codes at a higher rate for a more complicated patient visit. This code cannot be used at the same time as a 99491 visit either so CMS wanted to give providers who are more involved in the patient's care a chance at the higher reimbursement. Then if the next month it can return to clinical staff member or in XYZ duties they can continue and go back billing to the 99490 code. So if you're interested in learning more about chronic care management check out our past videos on chronic care management and complex chronic care management codes and If you'd like more information and videos like this one delivered straight to your inbox you can join the Pharmapreneur Community Newsletter at btpharmacyconsulting.com/newsletter Of if you're ready to get your CCM consulting business of the ground, join us on our next live webinar to learn more about the Pharmapreneur Academy! Click here to register for our next live webinar ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.
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I get so many questions about building a consulting business and in trying to answer them, I realized we don't really have good terminology around consulting...
YET! In fact, many people still confuse MTM consulting and Long Term Care Consulting. All these questions from colleagues interested in Consulting Careers are very difficult to answer without first IDENTIFYING and DEFINING your Business Model. Therefore, in order to help answer your questions better, I'd like to introduce and name the Top 5 Most Successful Consulting Business Models. 1. The MTM Consultant in a Community Pharmacy 2. The Consultant Pharmacist in a Physician Clinic 3. The Genetic Testing Consultant Pharmacist 4. The Health Expert Pharmacist Offering Cash-Based Services 5. The Expert Pharmacy Business Consultant We'll be discussing each of these in detail on our next live webinar, Sunday February 10th at 8:00p.m. Central On this webinar, we're going to be discussing the top five most successful consulting businesses and those that I help pharmacists build every day in the Pharmapreneur Academy. 1. The MTM Consultant in a Community Pharmacy Our number one most successful consulting business in the Pharmapreneur Academy is the MTM Consultant Pharmacist. Which I'll talk more about through my story and describe what that would look like for you as a consultant and how you can get that business started. 2. The Consultant Pharmacist in a Physician Clinic The number two top most successful consulting business models is the pharmacist that goes into a physician's office as a clinical consultant. As a clinical consultant pharmacist in a physician clinic, you could be doing chronic care management as an offsite subcontractor, you could be in the office performing annual wellness visits, diabetes education or even doing pharmacogenomic testing. 3. The Genetic Testing Consultant Pharmacist Which brings us to our third most successful consulting business model the genetic testing consulting. Now genetic testing is super exciting because we can use it to determine precisely which medications are the best choices for a patient's genotype. As a Genetic Testing Consulting, you would be responsible for identifying a patient's best optimized medication regimen using pharmacogenomic testing. Less studied, but still interesting to pharmacists in the functional medicine area, we can use nutrigenomic testing to identify any gene induced nutrient depletions. Also, now there are even new genetic test where they can tell you what type of exercises are best for your body. So it's a very cool field and we're seeing that blow up as well, and it fits nicely in with our fourth top most successful consulting model. 4. The Health Expert Pharmacist Offering Cash-Based Services The fourth top one is the health coaching or cash based consultant pharmacist. These consultants would be experts in certain health condition or maybe nutrition or CBD or something along those lines where they would be charging cash for their services. There are so many pharmacists interested in preventative care and lifestyle modification using holistic means. A growing trend in integrative or "functional" medicine, is sure to be linked to the current rising success of the Health Expert Pharmacist. The fifth and final business model is an expert in a different realm. Instead of health, this pharmacy consultant can help you achieve WEALTH. 5. The Expert Pharmacy Business Consultant And the fifth most successful consulting business is one I haven't talked about ever before! But I have had so many of you guys asking me that you've had success in your career in one thing or another and now you've got people reaching out to you wanting to learn how you do that thing you did. This this fifth consultant model is what I have transitioned into with the Pharmapreneur Academy. I started out as an MTM consultant in the community pharmacy and as the Academy in our following has grown. It's just been overwhelming how many pharmacists are reaching out to learn how to start their own businesses. My focus in the past Two years has shifted from me helping patients directly to me helping patients through teaching other pharmacists like you how to create your own consulting business. So we're going to go through all five of those in depth NEXT SUNDAY EVENING. I'm going to give you actionable tips and next steps to take to get your consulting business off the ground. So I hope you'll join us. You want to go register for the webinar. Again it's Sunday February 10 at 8:00p.m. Central. So I hope to see you next Sunday and learn from you what it is you're hoping to build in the business of your dreams. CLICK HERE OR REGISTER INSTANTLY BELOW! 
CMS Coding Changes for 2019
You may have been hearing about the new CCM code 99491 which codes for 30 minutes of Chronic Care Management time spent with a patient. The 99491 code for approximately 30 minutes of PROVIDER time spent on patient care reimburses at approximately $74. Whereas its "little sister" code 99490 codes for 20 minutes of CLINICAL STAFF time spent on patient care reimburses at approximately $42. The main difference for the jump in payment is in the nature that the new code reflects a DIRECT PROVIDER INVOLVEMENT. There was also a change in some remote patient monitoring codes and changes to some of the review of systems/past history for an established patient. Read my full write up in this week's Forum Post update in the Pharmapreneur Academy. 
ELEVATE SUMMIT PODCAST
Exciting news Pharmapreneurs! We just launched our podcast featuring interviews from the very first Elevate Pharmacy Virtual Summit If you aren’t familiar with the summit, it is a way for pharmacy professionals to earn continuing education hours by listening to interviews with experts in the industry from the comfort of your own home. "We love the virtual summit because it allows all members of our pharmacy team to watch the interviews and get excited about the content." When only one person from a team travels to a conference, it can be tough to relay that excitement and information to others. But now you can experience and share this content in a whole new way! If you're not a podcast junkie (yet) here's how to get onboard:
Season 1 of the Elevate Pharmacy Summit Podcast consists interviews about consulting in ambulatory care settings from: ⇢ Amina Abubakar ⇢ Joshua Akers, PharmD, BCACP ⇢ Nicholas Dorich ⇢ Mary Ann Kliethermes ⇢ Sandra Leal ⇢ Ashley Lorenzen PharmD BCPS ⇢ Kate Morton ⇢ Sue Paul ⇢ Michelle Thomas ⇢ DeArcy Vaughan, PharmD, MBA, BCACP, CDE, CTTS Listen to these interviews and get excited for this year’s Elevate Pharmacy Virtual Summit, May 8-12, 2019! You can get your free ticket at ElevatePharmacySummit.com 
CONSULTANT PHARMACISTS IMPACT ON PATIENT OUTCOMES AND PROVIDER BURN OUT
PRO TIP: if you’ve got a clinic in mind for pitching your consulting services, start a conversation with the decision makers using an article like this to pique their curiosity. Your “selling” conversations CAN feel authentic and Nikki (Nicole) Rausch is going to do a special training for Academy Members on “Authentic Sales Conversations: Warming Up the Cold Call” Tuesday, January 29 at 6pmP/8pmC. JOIN NOW TO GET ACCESS TO THE REPLAY! Read the full article here.
DO ADVANCED CERTIFICATIONS ENSURE SUCCESS?
As a pharmacist, you may be afraid of stepping outside your comfort zone to start your own business. I know I was. You may be wondering: - Should I get a board certification in ambulatory care? - Should I get an advanced certification? - Should I get my master’s in MTM? When I was getting ready to start my business in 2015, I was considering going back to school to get my MBA. I didn’t really need an MBA, I was just scared. Going back to school wasn’t scary, but starting my own business was. I’m here to tell you that you don’t need to get some advanced certification or more letters behind your name to guarantee your success in business. You can become a success all on your own. If this resonates with you and you’re looking to take that next step forward, join me Sunday, February 10th at 8pmCST, at my free webinar. I will talk to you about the top 5 most successful consulting business models. CLICK HERE TO GRAB YOUR SEAT
BUYING & SELLING
Have you considered becoming a consultant pharmacist, but stopped short after asking yourself something like: “How do I get a physician clinic to hire me when they can just hire another PA or APN?” Know that this is a LIMITING BELIEF and it’s NOT TRUE! The way a consultant PHARMACIST provides value is VERY DIFFERENT than other healthcare providers. It is important that you know and believe this if you are going to be successful as a consultant. Whether you’re selling skincare, real estate, or #consulting services, you have to genuinely believe in your product and believe it will help the person in front of you. If you don’t, that person will sense it. That is why I no longer lack confidence when talking about the Pharmapreneur Academy. I believe in my heart that it’s the best opportunity for pharmacists to start a PHARMACY CONSULTING BUSINESS. If I wasn’t 100% sure, I’d be referring you somewhere else! If you are struggling with limiting beliefs, consider joining the academy. I help members identify their unique value proposition, because you have to believe in your services before you can sell them! BONUS: Nikki (Nicole) Rausch - the Sales Maven - will be talking about these exact things on our January 29 member call!
PREDICTIONS 2019
Number six was my favorite prediction! “...examples of nontraditional partners coming together to deliver direct patient care. While some consider this a threat to traditional providers, close observers will notice disruption happening in both directions. Providers are also reinventing themselves for the future by expanding into retail, and health and wellness.” CLICK HERE TO READ THE FULL ARTICLE. THE 3 "LEGS" OF THE PHARMAPRENEUR ACADEMY Personal development is SO important for the business owner and the business. IN FACT I RECENTLY DID AN ENTIRE TRAINING ON PERSONAL AND PROFESSIONAL GOAL SETTING. The Academy has some specific recommendations for services, however much of it is business related advice (not clinical) and can therefore translate to many different business models in pharmacy. Most of our members are either implementing consulting services in the community pharmacy (health coaching, weight management, genetic testing, etc) or in an ambulatory care setting under a collaborative physician. We now have over 160 members in the Pharmapreneur Academy and many of them started with some of the same questions you probably have right now. We've got members ranging from brand-new entrepreneur to more advanced business owners who already have a consulting arrangement, but need help refining their model. There are essential 3 "legs" of the Academy: the e-Course, the Forums and the Monthly Member Calls.
The January member call is a training with Nikki Rausch, an expert in "Authentic Selling". It can be attended live or accessed via replay in the Academy Forums. The Academy is a good fit for pharmacists who are thinking about offering innovative services, but aren't sure exactly where to start. It is a very comprehensive business coaching program for pharmacists wishing to start offering advanced consulting services. Thanks so much for reading and I'll see you right here again next Month! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Honduras Mission Trip March 2006
"My goals for 2019 align with how I want to FEEL at the end of 2019 - Abundantly Blessed." My Big, Scary, Audacious goal is to have a successful business that will one day support my family and allow me to create a charitable foundation for medical missionary work. In this blog post from New Years Day waaaay back in 2017, I wrote about my 15 year plan to open a Mission Clinic in Central America. This year I've hit most of my top 10 goals...
Goal setting is important to me because it has allowed me to step away from jobs I don't love, charge what I'm worth and take chances on new ventures. Even though it wasn't on my "goal list" I created a new Planner based on the CORE FOUR Elements of the Healthy Business Helix. In my latest workshop, "Planning for 2019 Like a Pharmapreneur", I teach you the steps for choosing your:
The Planner, now available on Amazon, follows along with my latest Workshop. CLICK HERE TO REGISTER FOR THE "Plan Like a Pharmapreneur in 2019: Business Development" WORKSHOP!
Will you join me in setting your 2019 Personal Development Goals TODAY?
Click here to register for the free Business Development and Planning for 2019 Like a Pharmapreneur Workshop.
On the Workshop I share my process for goal setting and how I've come up with my 2019 Goals (listed below).
One of my "processes" is to choose a word to represent the year ahead. The word represents how I want to FEEL at the end of the year and throughout the year. It represents my focus. And as Tony Robbins says, "Where focus goes, energy flows" 2017 was a focus on VISIBILITY... 2018 was focused on INFLUENCE in order to create an awareness and evolution in pharmacy... In 2019 my focus is on ABUNDANCE. To me, abundance means having the freedom to pursue your purpose. It means bringing my message to more pharmacists, teaching about pharmacy consulting services and sharing my story genetic testing journey. My goals for 2019 align with how I want to FEEL at the end of 2019 - Abundantly Blessed. As you know, goal setting is very important to me. People who write down their goals are 42% more likely to reach them. I've been writing my goals and posting them on this blog consistently since 2016. And I've been writing my goals down in the notepad app on my phone consistently since 2014! Follow my entire journey here. However, the danger in focusing heavily on achievements, is that sometimes goal-oriented people (me) can get too wrapped up in the future and forget to enjoy the present. Hopefully focusing on abundance and gratitude for all that I already have will help me to be more PRESENT in 2019. Present for my family, my Academy members and myself. This year I want to add a "Lookback List" to my Annual Business Recap to celebrate things I am proud of and grateful for... Feel free to create your own and save it somewhere you can go back and look at it in the future when you're feeling down. Your notepad app on your phone is an EXCELLENT place to start this reflective practice. (If you need some help remembering all the amazing things that happened for you in 2018, go back and take a look at your paper planner or online calendar) Here's my "Lookback List" for 2018: January 2018 - Aven started dance lessons, first month post-partem, began shooting elevate summit videos, hung out with Ramit Sethi Feb 2018 - Family ski trip to St. Louis, took Natalie's e-course on strategic objectives, finished shooting summit videos March 2018 - threw myself a "Greatest Showman" themed birthday party, Elevate Summit launched, interviewed on Your Financial Pharmacist podcast April 2018 - rested after Elevate Summit, cancelled my whole life policy and upgraded my term insurance, went on a girls trip to Gulf Shores May 2018 - Began my NGx/PGx consulting business, on the Talk to Your Pharmacist Podcast, Started my health & genetic journey with MTHFR, Registered for PGx Certification course June 2018 - PioneerRx Connect event/CMA Fest in Nashville with my husband, 5 Ways to Take Your MTM Consults to the Next Level webinar, VIP day with sales coach Nikki Rousch, finished PGx certificate July 2018 - Jurassic Quest in Memphis for Aven's birthday, Elevate Adherence Mini-Summit, Weekend family trip to Mountain View, VIP day with speaking coach Carol August 2018 - resurrected my Youtube channel, special day with Mom and Aven, created 2019 Business Development Planner for Female Pharmapreneur Workshop and Mastermind Sept 2018 - VIP day and conference with business coach Shane, hosted the Female Pharmapreneur Workshop and Mastermind in Nashville for 8 amazing female pharmacists, completely changed pricing for Academy and added 50 new members, appeared on Rx Buzz Podcast with Ashlee Klevens Hayes October 2018 - NCPA conference in Boston with my husband, listed home for sale and made offer on a new one, (and looking forward to Halloween with the kids) November 2018 - Elevate Diabetes Care Mini-Summit, BizChix Live conference in Southern California, amazing massage, Harry Potter World, creating Lesson 12 December 2018 - Closed on new home, Pharmapreneur Academy Scholarships, Hoyt's first birthday, celebrating Christmas in our new house, taking time off My Top 10 Goals for 2019 (written in past tense as if it were December 2019)
The "word" that I've chosen to represent the feeling I want to have at the end of 2019 is ABUNDANT. Right now, I'm already feeling that way, but I know there's always room for improvement. Will you join me in setting your 2019 personal development goals? ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.  What would your life look like if your "side hustle" was earning you an additional $1,500 a month? What would you do with it? Pay off your students loans faster, save it in your retirement, spend it on a new home, reinvest it into the business, take that Bucket List Trip in 2019... Now imagine: What if your business started earning $15,000 a month? $150,000 a month? It sounded crazy to me at first too, but I have plenty of entrepreneurial friends for whom this is a reality. That is the beauty of building your own business. There's no limit to your earning potential. This simply isn't the case in 99.9% of "normal jobs". When you build a business, especially one that doesn't require your direct involvement, you're no longer trading your time for money. Entrepreneurs can leverage their time to exponentially increase their income. And so can you! Not saying this isn't a LOT of WORK. The time you'll spend on the front end of building your business will probably take longer and require more investment of your time and money than an employed position. I've heard this called front-loading the sacrifice. The author, Doc Green of DiverseFi, was relating it to savings and investing, but I'm relating it to building a business.
I recently wrote about the Types of Consulting Businesses a Pharmacist Can Build. For example, say your goal is to build your health coaching business for women trying to conceive... There are some steps I recommend to go through BEFORE you ever start marketing yourself to potential clients. The 12 week goal-setting process:
Want my full training on this process? Join the Pharmapreneur Academy today and get INSTANT ACCESS! Imagine your Big Annual Goal is to make $25,000 in your new consulting business. Prioritize the TOP 3 Quarterly Objectives that you think will get you to that number. Break your Big Annual Revenue Goal into Monthly Metrics. ex) $25,000/12 months = $2083/month Each week, you know you have an extra 8 hours in which you can see these clients. Now, base your services around that number. ex) $2083/8 hours = $260/hour Perfect! Now do you want to see one client 4 times per month? 2 times per month? 1 time per month? This is will give you an idea of how many clients you are looking for and what packages you'd like to offer them. The example we're using for this consulting business scenario is with women trying to conceive, so lets continue with it. It would make sense to see this client twice a month, during specific times in their cycle. So you'll need to sign up 4 clients for say 6 months at a time. Thats 8 clients total for the year. Sounds doable right! Now, the million-dollar question, how do you GET SOMEONE TO HIRE YOU to do this? That is exactly what I will walk you through step-by-step in the How to Build a Pharmacy Consulting Business e-Course. Lesson 12 goes through an advanced training on building a cash-based service business. LESSON 12 - Cash-Based Services - Online and Off
We'll also be hosting a special January Members Only Q&A Call on Sales Training called "Warming Up the Cold Call" with The Sales Maven Nikki Rousch. Of course, you can figure this out on your own, but remember your 12 week goal? Investing in a program like the Pharmapreneur Academy will saves you dozens of hours, maybe even months of wasted time, money and energy. The Academy will give you exactly what you need and steer you away from spending resources on the things you don't. The e-Course is open again now, but only for a short time. If you want to save time, money and make progress on changing your life with that extra money each month, join us in the Academy and start your "side hustle" today. What would YOU do with an extra $1,500 each month? Join our next live webinar "Whats Working in Consulting for 2019" by clicking here to register! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
This is probably the biggest question on your mind if you are just finding my site, right?
If you have been here before, then welcome back my friend! But for those of you just finding me, I get this question alot so I've decided to construct an article that will hopefully answer this question. However, be warned, this information may cause the following symptoms: excitement, nervousness, insomnia, perma-grin, racing thoughts, irregular heartbeat and much more! In all seriousness, there are as many types of consulting businesses as an innovative pharmacist can imagine. With provider status knocking at our door, learning your options NOW can help save you time and money in the future. It can help you become THE pharmacist to call! Let me first start with my story. I started my business because I lost my job in 2014 when I was 6 months pregnant. At that point I was able to scrape together some “prn” work to make it through my maternity leave. After I had my daughter, I knew that I didn't want to go back to long hours in big box retail pharmacy. My family's finances depended on me so I knew I needed to make my relief and consulting business work. I began managing the MTM program for a local pharmacy. As I learned more and more about MTM, I began to share it on my blog and LinkedIn. Pharmacists began contacting me for advice about how they could begin consulting. I talked to so many pharmacists who were very unsatisfied and it broke my heart. Here I was loving my MTM business and trying to market my business to grow it locally when others obviously need my help globally. In September 2015, I put together a coaching program and took on three clients. I kept detailed notes of our conversations. I soon identified common barriers and similarities in the questions they asked. I began outlining all the information that I was sharing with them. In December 2015, I pre-launched the online e-course. 8 people joined the beta test group. Then launched again in March, 16 more joined. After working out some of the "kinks", I re-shot the entire course, increased the price and added more members. In June 2016, I launched Lesson 7 on CCM and PQRS. In September 2016 Lesson 8 on CPAs, pharmacotherapy MTMs and TCM. You see I never set out to build a community that has helped over 250 pharmacists learn about consulting services. If I had, it would have been too overwhelming. My unique point of view is that pharmacists need to prove their value by developing relationships and PROVE their value. This may not equate to a bloated six figure retail pharmacist salary (whoa, does she mean THAT?). Yes, it may be an unpopular opinion, but I feel that the high salary community pharmacists enjoy can actually hold them back. I've heard this called the "golden handcuffs", which is a fitting term. Many times those handcuffs are also connected to crushing debt (student loan or other). What peeves me the most is when people expect everything to be done for them. They want someone to create a dream job for them, then ask them to come do it. That is not the way it works. You must CREATE the Dream Job YOURSELF. Now, I am ready to help pharmacy take part in a larger conversation about innovation in healthcare. How can we do it better, cheaper, more connected and truly patient-centric. This, I believe, can only be accomplished through interoperability. The first step to achieving this interoperability is to connect pharmacies, clinics and acute care settings. This can be done through collaborative practice agreements and pharmacist led clinical services. Next we will do it with software, even AI, who knows. Which brings me to the innovative pharmacist who wants to start a consulting business. The options they have and how to get started. If you don't want to get stuck behind the wave of clinical pharmacy consultants, keep reading (it will be worth it). So What are Some Types of Consulting Businesses? 1. The implementation specialist This person would focus on helping community pharmacies implement sustainable MTM programs. They would focus on staff training, organization, setting up systems and automating the MTM process as much as possible in the pharmacy. They would help the store put in place protocols and procedures for all staff members to be trained in MTM. More information about organizational systems and staff training is contained in Lesson 4 of the e-course. 2. The program improvement specialist This person would consult with pharmacies to help them improve existing programs. These programs could include, but not be specific to MTM, CPAs or other clinical services. The consultant would conduct a SWOT analysis on the pharamacy and propose changes based on the assessment. Some areas of improvement may be to improve physician collaboration, improve patient adherence measures, complete more CMRs or add community services such as vaccination clinics. More information about how to improve clinical programs is contained within Lesson 5 of the e-course. 3. The management consultant This person may work closely with software companies, telehealth companies, diagnostic testing companies, etc. to help them improve collaboration with community pharmacies or patients. Check out my interview with Deloitte management consultant Sonal Shah to get a few more ideas. 4. The physician clinical consultant Many pharmacists are becoming increasingly interested in partnering with physician groups. It can bring personal fulfillment to the pharmacist and a valuable service to the physician group. A few ways pharmacists can help physicians is by coordinating a chronic care management (CCM) program for the clinic. By focusing on physician quality reporting system (PQRS) measures a pharmacist can put together a care plan that will help improve patient outcomes and prevent penalties from newly introduced MACRA legislation. Pharmacists can also offer services such as TCM, MTM polypharmacy consultants and PGx testing. More information about this can be found in Lesson 7 of the e-course. 5. The point of care testing services consultant This person would be an expert on collaborative practice agreements that would allow pharmacies to implement CLIA-waived point of care tests. Such test may include pharmacogenomic consultations, rapid diagnostic screening tests, preventative screenings or even narrow therapeutic window medication testing. More information about point of care testing services can be found in Lesson 8 of the e-course. 6. BONUS - The "Health Coach" This actually may be the first consulting business that comes to top of mind when thinking about consulting services. I intentionally placed this one last because I believe that it has the smallest chance of supporting a successful business model. UNLESS you know what you're doing. Creating a niche cash-based business models where patients would pay the pharmacist on a per appointment basis to be a "health coach" or anything like it. If you are interested in this type of consulting business, we've just released Lesson 12 in the e-Course at the Pharmapreneur Academy on Offering Cash-Based Consultant Pharmacy Services! This Lesson is perfect for functional medicine pharmacists, nutrition and weight management programs, genetic testing consultants and specific disease state specialties. So what else WILL you find inside the E-course and Community?
Still not sure? Email me and share your reservations. Or, if you think the Pharmapreneur Academy may help you accomplish your goals, click here to join our next Live Webinar! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.  "Lesson 12 is great for pharmacists interested in functional medicine consulting, pharmacogenomic and nutrigenomic testing, offering weight and hormone management programs!" After three years of building the Pharmapreneur Academy, I finally have created a step-by-step model for pharmacists who want to offer cash-based services.
I've been resistant to do this since cash-based services take a different approach, may be targeted at a different patient demographic and can be a tougher "sell" for a budding entrepreneur. As you'll see in the E-Course Lesson Outline below, our LESSONS start at the beginner level and build up to the more advanced consultation services. Cash-based services can be the most difficult to get off the ground, BUT these services can provide patients immense value and GREAT FINANCIAL rewards you without the hassle and oversight of insurance payers. Back in March, when I started my Genetic Journey, I created a Genetic Consults business that I launched as a cash-based program to see if patients would be willing to pay for pharmacogenomic and nutrigenomic testing services. I documented everything I did and everything I learned about offering a cash-based "health coaching" program. In LESSON 12 of the e-Course at the Pharmapreneur Academy, I share everything I've learned about what works and what doesn't about business, marketing and "selling" your cash-based services. Lesson 12 is great for pharmacists interested in:
LESSON 12 - Cash-Based Services - Online and Off
Can you see why I'm excited to release Lesson 12? You've never seen a business training like this in the world of pharmacy! Since we've gone through our most recent Lesson in the e-Course at the Academy, lets now take a look back at the first 11 Lessons. LESSON 1
LESSON 2
LESSON 3
LESSON 4
LESSON 5
LESSON 6
LESSON 7
LESSON 8
LESSON 9
LESSON 10
LESSON 11
As you can see, there is something for everyone in the E-Course at the Pharmapreneur Academy. All these trainings and much more are included for free with your membership. To join before December 31st, go to PharmapreneurAcademy.com and get INSTANT ACCESS for only $197! Still have questions? Join our next live webinar "What's Working in Consulting in 2019" on Sunday, January 6th at 8pmCST. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website.
Normally every November we give away one scholarship to the Pharmapreneur Academy (value of $997).
But THIS YEAR is different. We've COMPLETELY CHANGED the pricing structure of the Academy because I wanted more pharmacists to be able to join and get access to information about consulting. Our members get RESULTS, but I hear from pharmacists everyday who are struggling in their careers and feeling "stuck". The Pharmapreneur Academy allows you to get "unstuck" and finally move forward with your consulting business. Because of my commitment to reach more people, I've decided to give away TWENTY FIVE Scholarships this year! That's right, it's the Holidays and I want to be generous with this valuable information. If you've been thinking of joining the Academy, but haven't been able to because of financial obligations, apply for one of our 25 scholarship spots. Here's what I want to know about YOU:
All you need to do is APPLY BY ENTERING YOUR INFO below. Remember, one of my 2018 goals was to HUGELY & UNEXPECTEDLY bless someone? Well, I've decided to bless 25 someones! The Scholarship recipients will have free access to the Academy for 30 days. This includes full access to:
We expect the Award recipient to participate and be an active member in the Academy.
If you have any questions about the Scholarship, email me at blairthielemier@btpharmacyconsulting.com ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
"It's absolutely excellent! Did you decide to begin building a new career this year? Or finally start that business you've always wanted to? Or take that course you've been thinking about? For the past three years, I have been publishing articles about goal setting to kick off the new year. It has been a way to hold myself accountable, keep track of my successes (and failures), and because of it I believe I enjoy life more fully than some do in a lifetime and hopefully inspire others to do the same. Year after year, I stress the importance of creating goals for your life (personal relationships, financial, career and health/self-care). Goal setting has allowed me to step away from jobs I don't love, charge what I'm worth and take chances on new ventures. If we hadn't started setting some Family Financial Goals back in 2013, I don't think I would have as many opportunities and options as I do today. We'd still be "paying interest and not ATTENTION" in the words of Dave Ramsey. In fact, we've been using a combination of Mint, Betterment and the notepad app on my phone consistently since 2014 to successfully nearly double our SAVINGS AND EARNINGS rates. Some of those goals include:
Check out my 2016 Goals and my first year in Online Business here. Check out my 2017 Goals and my second year in Online Business here. Check out my 2018 Goals here. If you haven't yet, now is the time to start planning your Personal and Career Growth by setting your goals for 2019. I set Big Annual Goals in four areas of my life:
In our new Business Development Workshop I teach you my process for setting your Business/Career Goals and share my own 2019 Goals. Goal setting has allowed me to step away from jobs I don't love, charge what I'm worth and take chances on new ventures. Even though it wasn't on my "goal list" for 2018, I thought it would be fun...so I created a new Planner based on the CORE FOUR Elements of the Healthy Business Helix. The 2019 Business Development Planner, now available on Amazon, follows along with my latest Business Development Workshop: Planning for 2019 Like a Pharmapreneur. "You must plan ahead to achieve anything great. " This Business Development Workshop will introduce you to my Business Development Framework, designed to walk you through the Core Four Elements of Productive Planning to Achieve Your Career Goals. The Framework will walk you through the Core Four Elements of:
I love goal setting and I hope this Workshop will help you set some Personal, Career, Financial and FUN Goals for 2019! Click here to register for the free Planning for 2019 Like a Pharmapreneur Business Development Workshop. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
I haven't yet publicly shared the moment that caused me to begin looking into my own genetic variants, but I can tell you exactly when I had my "ah-ha moment".
December 28th, 2017 at 1:25pm My son was just born and the neonatologist was doing his assessment. Under the yellow light of the exam table, I noticed her looking closely at the base of his spine. I asked her if something was wrong. She said, "I'm looking to see if I can see the bottom of this hole, if I can't see the bottom we'll have to do an ultrasound." I told her that his sister had the same dimple and she was fine. This seemed to satisfy her. But when I looked at it, she was right, this was MUCH MORE than a dimple. You cannot easily see the bottom of the tiny hole at the base of my son's spine. The information about my daughter seemed to ease the neonatologists concerns, but it got me thinking...
So many things go through your head when you are caring for a newborn, but for me in the back of my mind I knew there was something I needed to look into further. I've been interested in Pharmacogenomic testing for the past few years, but I decided to start my precision medicine journey by testing myself. A few month after my son's delivery, I began my genetic journey by taking a 'direct to consumer' DNA test... When I got the results of the DNA test kit back, I was flagged for having a higher than normal risk of CV disease, Parkinson's and Alzheimers. In digging through the results, found out I can’t methylate folic acid - it’s approximately 7% of normal methylation capacity. I also learned that 40% of the population in the United States has some form of this mutation, but checking for it is not a standard of practice. The gene MTHFR codes for an enzyme that performs functions involved in building proteins and detoxifying cells. The mutation causes the enzyme to function inefficiently, causing inflammation in the brain and elevated homocysteine levels. This leads to inflammation throughout the body, circulatory system and especially the brain, causing higher risk for developing cardiovascular disease and neurological diseases like Parkinson’s and Alzheimer’s. This all pointed back to my genetic mutation causing dangerous nutrient deficiencies like the one that caused my son’s near-neural tube defect. As a result of the genetic test, I’m able to take the exact supplements my body needs to combat inflammation and hopefully decrease my risk of developing a neurological disease. My experience has motivated me to want to help others, especially young women trying to conceive. FOLIC ACID MAY NOT WORK FOR YOU. We are also seeing genetics linked to depression and ADHD, so my genetic consulting program focuses on testing children on psychoactive medications for a genes that impact how well the brain makes and clears dopamine, serotonin, and the neurotransmitters that affect memory and concentration. This provides a preventative option, offers potential alternative to stimulant medications and prevents “trial and error” prescribing. Shortly after I tested myself, I got certified in Pharmacogenomic testing. Then I became trained in Nutrigenomic testing. Then, I decided to start seeing if I could help others with my newfound knowledge. I took 3 beta testing patients, then the word spread. Friends and family began asking me if I could test them too. I worked with over a dozen 'beta testers' before I felt very confident in my services. I identified children with ADHD and on psychiatric medications as an area of interest of mine. I took on a few patients. After one of my recent consults, I had given the mother a list of about 10 things to try before starting the child on a stimulant medication. She was ecstatic. She told me she thought that I would tell her that nothing could be done and medication was their only option. If you've read my blog posts about starting my Genetic Consults business, then you know I was able to get the business up and running in just a few months. I didn't do it because I wanted to build a second business. No, my main focus is helping pharmacists build their career by building consulting businesses through the Pharmapreneur Academy. I treated the Genetic Consults business as an experiment so I could turn around and teach other pharmacists how to create a similar model. I'm working on putting together a wealth of information on cash-based services in Lesson 12 of the e-course at the Pharmapreneur Academy, which is launching December 16th, 2018. Lesson 12 is great for pharmacists interested in functional medicine consulting, pharmacogenomic and nutrigenomic testing, offering weight and hormone management programs! CLICK HERE TO LEARN MORE ABOUT HOW THE E-COURSE AT THE PHARMAPRENEUR ACADEMY CAN HELP YOU FULFILL YOUR CONSULTING DREAMS. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Want to watch a video version of this post? I've got you covered!
What is Nutrigenomic testing and how can a pharmacist use it in patient wellness consultations and supplement recommendations?
Nutrigenomic testing is similar to pharmacogenomic testing except we are looking at genes that specifically have to do with nutritional deficiencies. What genes are you testing? Some commonly tested genes are MTHFR, MTRR and FOLR1. These three genes are directly related to the methionine pathway and can impact the patient's homocysteine levels and folic acid levels. Some other genes that we're looking at and testing with Nutrigenomics is GAD1, GSTM, interleukins and HLA-DQA1 which is an indicator of gluten intolerance. There are no CPT codes that code for nutrigenomic testing and testing is not covered by insurance. Most of the pharmacists offering nutrigenomic and health and wellness consults are charging the patients cash. The cash price to the patient would include whatever test you'll be running, plus the consultant pharmacist's consultation fee and then certain supplement recommendations. On top of the pharmacist's consultation fee some opportunity for pharmacists to impact patients in nutrigenomic testing is to offer supplement recommendations as part of a health and wellness consult that identifies what nutritional deficiencies. The consultant may need to address any changes in diet that the patient may need to undergo as well to help impact and improve their genetic makeup by modifying gene expression (epigenetics). How could a consultant pharmacist offer nutrigenomic tests? In addition sometimes a nutrigenomic test can identify opportunities for pharmacogenomic testing. For instance some nutrigenomic tests, will test the COMT gene and the MTHFR gene which we also see on many pharmacogenomic panels. Pharmacists are seeing an opportunity to help patients through offering them high quality supplement recommendations and by using natural products like CBD oils. As more and more patients are looking for a more natural and holistic approach to medication therapy and preventative medicine, consultant pharmacists who are interested in functional medicine can use nutrigenomic testing to identify and remedy nutrient deficiencies that the patient may be experiencing. How can you put a program like this together? A consultant pharmacist in an off site setting such as a community pharmacy or independent consulting firm could provide nutrient deficiency consultations, microbiome and food sensitivity testing, nutrigenomic testing and weight management as part of a holistic health and wellness consultation program. If you are interested in building your clinical services... Join us on our next LIVE webinar to learn more about Pharmacy Consulting and the Pharmapreneur Academy. We'll discuss Protecting Yourself From Career Climate Change with Consulting as a Side Business Register now! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Want to watch a video version of this post? I've got you covered! What is Pharmacogenomic (PGx) Testing? Pharmacogenomic testing is identifying genes that may affect enzymes responsible for hepatic metabolism of certain medications. Remember back in pharmacology and genetics you may remember learning about the Cytochrome P450 enzymes. Those enzymes are some of the ones that we look at in a pharmacogenomic test. What Genes Are Tested? In addition to the CYP450 enzymes, we also look at HLA-A and HLA-B, which indicate the presence of alleles linked to hypersensitivity to carbamazepine or phenytoin. We also look at OPRM1 which in our mind geotag specifically shows a decreased sensitivity to analgesic but it could go either way. We also look at the COMT which indicates whether or not the body is producing enzymes that can clear dopamine norepinephrine from the synapse. We also look at SLCO1B1 which tells us if the patient is more at risk for statin-induced myopathy. And finally for thrombosis risk we can look at genes that code for Factors 2, 5, and 10 Leiden. How Do You Bill for Pharmacogenomic Testing? As far as CPT codes go, there are no CPT codes that code specifically for pharmacogenomic testing. The patient can be referred to the pharmacist or to the physician for pharmacogenomic testing based on the medications that they're on and based on their diagnosis. Some impactful activities for pharmacists wanting to offer pharmacogenomic testing either in their community pharmacy setting or in a physician's office setting are:
To refer back to the incident to billing criteria, check out our last video on incident-to billing. How can you put a program like this together? A consultant pharmacist in an off site setting such as a community pharmacy or independent consulting firm could integrate pharmacogenomic testing and consultation into an MTM visit Lesson 9 in the E-course at the Pharmapreneur Academy is ALL about Pharmacogenomic and Point of Care Testing Services! If you are interested in building your clinical services... Join us on our next LIVE webinar, Sunday, November 18th at 8pmCDT Learn how to Protect Yourself From Career Climate Change with Consulting as a Side Business and how the Pharmapreneur Academy can help you build the Career of Your Dreams! Register HERE. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Want a video version of this post? What is comprehensive medication management and how does it differ from continuous medication management? Comprehensive Medication Management is a program created by CMS to be included in the new Comprehensive Primary Care Plus (CPC+) clinic model The CPC+ model was created by MACRA as part of an advanced APM. Now remember in MACRA, there's two different payment tracks that clinics and providers can choose the MIPs route or the advanced APM route. The CPC+ model is application-only and it's only available in certain states and regions. "There are 2,900 primary care practices currently participating in Comprehensive Primary Care Plus (CPC+) in 18 regions: Arkansas, Colorado, Hawaii, Greater Kansas City Region of Kansas and Missouri, Louisiana, Michigan, Montana, Nebraska, North Dakota, Greater Buffalo Region of New York, North Hudson-Capital Region of New York, New Jersey, Ohio and Northern Kentucky Region, Oklahoma, Oregon, Greater Philadelphia Region of Pennsylvania, Rhode Island, and Tennessee." There are two different track models a CPC+ clinic can opt in to. In Track 2, there's an option mentioned to improve care through comprehensive medication monitoring. The idea behind comprehensive medication monitoring is to develop a plan after discharge or for those patients receiving longitudinal care management. There are four primary "change tactics" mentioned in Track 2 of the CPC+ model:
My thoughts for a program that includes a clinical pharmacist like this could include services like:
Providing comprehensive medication management programs and a CPC+ model is an opportunity for consultant pharmacists to help providers and focus on patient care outcomes. If you are interested in building clinical services like comprehensive medication management... Join us on our next LIVE webinar, Sunday, October 21st at 8pmCDT Learn the TOP 3 Mistakes Pharmacists Make in Their Careers and how the Pharmapreneur Academy can help you build the Career of Your Dreams! Register HERE. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
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What counts as a transition of care?
Eligibility:
Many time a post-discharge Transitional Care Management Service can be integrated into an existing CCM program. What are the CPT Codes for billing? 99495 ~$164 for non-facility setting ~$135 for facility setting Includes:
99496 ~$231 for non-facility setting ~$197 Includes:
What services a Consultant Pharmacist could offer to patients undergoing Transitions of Care?
How can you put a program like this together? A consultant pharmacist in an off site setting such as a community pharmacy or independent consulting firm could provide the primary touch point for a patient in the 48 hours post discharge. This consultant would need to be engaged in a financial relationship with the physicians office and generally needs to be under a collaborative practice agreement, though not exclusively necessary. Lesson 7 in the E-course at the Pharmapreneur Academy is ALL about the CCM and TCM codes for billing for pharmacist services! If you are interested in building your clinical services... Join us on our next LIVE webinar, Sunday, October 21st at 8pmCDT Learn the TOP 3 Mistakes Most Pharmacists Make in Their Careers and how the Pharmapreneur Academy can help you build the Career of Your Dreams! Register HERE. ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
On Saturday, September 22nd, 2018 nine female pharmacists met in Nashville, TN to spend a day together working ON our businesses and identifying ways to support one another.
Masterminding is a concept made famous by Napoleon Hill's classic "How to Think and Grow Rich". Wikipedia describes Masterminding as... A mastermind group is a peer-to-peer mentoring concept used to help members solve their problems with input and advice from the other group members. The concept was coined in 1925 by author Napoleon Hill in his book The Law of Success, and described in more detail in his 1937 book, Think and Grow Rich. In his books, Hill discussed the idea of the Master Mind, which referred to two or more people coming together in harmony to solve problems. Recently, small business owners have taken this concept to a whole new level in the "facilitated Mastermind". A facilitated Mastermind is a formal meeting of entrepreneurs who come together to help each other with their businesses. The best facilitated Masterminds are between 6 & 8 people, diverse enough to support each others strengths and weaknesses and homogeneous enough so that the business owners are at similar points in their business journey. I, myself, have been involved in Masterminds throughout my business journey. In 2016, I participated in a 6 month Mastermind with other women with online businesses. In 2017, I participated in a 9 month Mastermind with other women with 6-figure businesses which were both online and brick and mortar. And this year in 2018, I'm working directly with two other business owners one male, one female who are at the 7-figure business level in hopes to learn from them and grow the impact of the Pharmapreneur Academy. Pharmacy's First Formal Mastermind Event The Female Pharmapreneur Business Development Retreat was pharmacy's first (to my knowledge) facilitated Mastermind ever. Represented by our group was 8 states: Arkansas, California, Colorado, Georgia, Kentucky, Missouri, Oklahoma and Tennessee. Also represented was various specialties, from compounding to non-profit to insurance payers to naturopathic medicine. It was truly a very special group and something I hope to offer again in the near future. I also want to thank Live Oak Bank for sponsoring part of this event and for sharing information with us on the various opportunities for investing in our business and calculating a return-on-investment. 
The structure of the day's agenda:
Upon completion of the Workshop, each attendee was presented with their own copy of the 2019 Business Development Planner, now available on Amazon. Our Homework for the Retreat was to:
Also, we committed to staying focused on actions that move us closer to those goals and give us permission to say "NO" to opportunities that don't align with those goals. As nine women gathered together, we felt the power of diverse backgrounds, diverse ways of thinking and the collective power of the Master Mind. It was truly a magical experience and something I plan to offer again in 2019. If you're interested in our next event, let me know and I'll add you to our waiting list. To stay in contact with all the happenings in the Pharmapreneur Academy Community join our mailing list at BTPharmacyConsulting.com/Newsletter ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
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Medicare Part B covers medical nutrition therapy (MNT) services and some related services that integrate nicely with what a Consultant Pharmacist can offer.
However, MNT must be provided by a registered dietitian or a nutritional professional who meets certain requirements. This is a GREAT option for pharmacists who also have a professional background in nutrition. Even though MNT can only be provided by a nutrition professional, it still MUST be ordered by a doctor. MNT services may include:
A pharmacist with a nutrition degree could provide MNT services as an off-site consultant. For patients being treated in a dialysis facility, Medicare covers MNT as part of your overall dialysis care. Codes and Criteria: 97802 – MNT; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes 97803 – MNT; re-assessment and intervention, individual, face-to-face with the patient each 15 minutes 97804 – MNT; group (2 or more individual(s)), each 30 minutes G0270 – MNT reassessment and subsequent intervention(s) for change in diagnosis, individual, each 15 minutes G0271 – MNT reassessment and subsequent intervention(s) for change in diagnosis, group (2 or more), each 30 minutes
How you can utilize this code: MNT should not be confused with diabetes self-management training (DSMT), however. DSMT is an education and training program that helps patients manage their diabetes, whereas MNT consists of more individualized diagnosis, therapy, and counseling related to nutrition. According to the American Dietetic Association's 2009 White Paper on Nutrition Services that distinguishes between the delivery of DSMT and MNT services, the DSMT curriculum that is accredited by Medicare consists of 1 hour of individualized assessment and 9 hours of group classes. DSMT curriculum is focused on “incorporating nutritional management into lifestyle,” and “using medications safely and for maximum therapeutic effectiveness.” Sometimes it may be most helpful for patients to receive DSMT first, followed by MNT. Other patients may receive DSMT and MNT simultaneously. A consultant pharmacist may partner with a nutritional professional to offer a collaborative DSMT/MNT program. What services are you implementing in 2019? Leave me a note in the comments or join our Pharmapreneur Community Newsletter and email me directly! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Want a video version of this post? I've got you covered! Diabetes self-management training (DSMT) is an education program that can be provided to eligible newly diagnosed Medicare beneficiaries. Patients are eligible for 10 hours within the first year of diagnosis and then 2 hours each year thereafter. Education can be provided via group sessions (> 2 patients) or individually, though individual education must be justified. CPT Codes G0108, individual, per 30 minutes and G0109, group session, per 30 minutes Criteria
Eligibility Who Is Covered? Certain Medicare beneficiaries when all of the following are true:
Frequency? Initial year: Up to 10 hours of initial training within a continuous 12-month period Subsequent years: Up to 2 hours of follow-up training each year after the initial year
Opportunities for Consultant Pharmacists to Use the Codes DSMT probably has the most difficult criteria to meet since the organization must be accredited by either the ADA or AADE. However, overall gaining accreditation isn’t too difficult and if you are partnering with a provider who sees many diabetic patients helping them gain accreditation opens up an additional revenue stream. Once accreditation has been established you can partner with the physician to provide DSMT. Remember, DSMT must be ordered by the provider first. Then the pharmacist can deliver the service. It does not require a collaborative practice agreement unless you are making changes to the patients therapies. Just as with the diabetes prevention programs, if monitoring patient data such as blood sugar, weight, or physical activity electronically you can also utilize the remote patient monitoring code. The next opportunity we'll discuss is Medical Nutrition Therapy. Sign up for the Pharmapreneur Community Newsletter and get it delivered directly to your Inbox! ABOUT THE AUTHOR: Amy Henneman, PharmD, BCACP, BCPS, CDE is an associate professor of pharmacy practice living in south Florida with her husband and two children. Her practice has been focused in building ambulatory care services and working to provide expanded care to low income patients. She enjoys working with both providers and other pharmacists to assist them in offering expanded pharmacy services. 
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Remote Patient Monitoring: An Opportunity for Consultant Pharmacists?
Effective January 1st, 2018, the Centers for Medicare and Medicaid Services will begin reimbursing for remote patient monitoring (RPM). So, what is RPM? For starters, NOT telehealth services, which is actually a good thing. While telehealth services do exist, they have several specifications that can make widespread use a little tricky. So what about RPM? RPM is the use of digital technology to collect health data from a patient that is then transmitted electronically and securely to a healthcare provider in another location for assessment and recommendation. CMS is now going to reimburse providers for that assessment and recommendation portion, if it constitutes at least 30 minutes of provider time per month, using CPT 99091. This means for those patients participating in home glucose or blood pressure monitoring, INR, and even potentially genetic reports, the provider now has the opportunity to receive approximately $60 per month for their time spent reviewing, assessing, and making recommendations regarding the patient’s care plan. So what are the specifications? Most notable is that CMS stated the service must be provided by the practitioner, not clinical staff. For now, using this code means utilizing incident to billing. Consent must be obtained and documented from the patient, and for all new patients or those that have not been seen within the last 12 months, they must have an initial visit. The code can be billed once per month for each patient as long as the practitioner is receiving information electronically that impacts the patient’s care. This opens another potential revenue stream for savvy Pharmapreneurs. For pharmacists partnering with physicians to offer MTM or consulting services who meet the criteria for incident to billing, this is another service you can offer to your providers. If you are already spending time reviewing medications and/or making adjustments to medications, most likely this service is an extension of what you are already doing. Before making a recommendation or an adjustment to a patient’s insulin regimen, you probably want to see the patient's blood sugar logs. If the patient is able to send them electronically, there’s an opportunity to utilize RPM. If you are already using the chronic care management codes (CPT codes 99487, 99489, and 99490), RPM can be billed in conjunction with these. As CMS moves towards innovation and expanded integration of technology, this means big opportunities to be on the forefront of this move forward. Remote Patient Care Monitoring is the use of digital technology to collect health data from a patient that is then transmitted electronically and securely to a healthcare provider in another location for assessment and recommendation. CPT Code 99091 The Center for Medicare and Medicaid Services (CMS) reimburses providers for that assessment and recommendation portion, if it constitutes at least 30 minutes of provider time per month. Billing Criteria The service must be provided by the practitioner, not clinical staff. So for now, using this code means utilizing incident to billing. Consent must be obtained and documented from the patient, and for all new patients or those that have not been seen within the last 12 months, they must have an initial visit. The code can be billed once per month for each patient as long as the practitioner is receiving information electronically that impacts the patient’s care. Information transmitted electronically must be transmitted in a protected manner. Opportunities for Consultant Pharmacists For pharmacists partnering with physicians to offer MTM or consulting services who meet the criteria for incident to billing, this is another service you can offer to your providers. If you’re thinking diabetes management the first thing you should think of is blood sugar monitoring. Home blood sugar monitoring is necessary for most patients and something we ask for often. This information could be transmitted electronically and the time you spend reviewing the information billed for using this code. Additionally, if you partner with a provider to offer a diabetes prevention program or diabetes self-management training, electronic transmission of items such as patient weight and physical activity could also qualify for remote patient monitoring, giving you more bang for your time. The next opportunity we'll discuss is remote patient monitoring. Sign up for the Pharmapreneur Community Newsletter and get it delivered directly to your Inbox! ABOUT THE AUTHOR: Amy Henneman, PharmD, BCACP, BCPS, CDE is an associate professor of pharmacy practice living in south Florida with her husband and two children. Her practice has been focused in building ambulatory care services and working to provide expanded care to low income patients. She enjoys working with both providers and other pharmacists to assist them in offering expanded pharmacy services. 
Want a video of this content? Opportunity for Consultants: National Diabetes Prevention Program While this program has been around for many years, it has only been since 2016 that these programs have been billable under Medicare. So, what is a diabetes prevention program? Simply, it is a lifestyle change program intended to prevent or delay the onset of type 2 diabetes. While there are many lifestyle change programs available in many communities, the ones that are eligible for reimbursement under Medicare are ones that are recognized by the Centers for Disease Control and Prevention (CDC). Code: G code, G9873 - 9885 So what do you need to know: National Diabetes Prevention Programs can be offered by any individual or organization as long as they meet criteria to become a CDC recognized provider. CDC criteria include the following:
Ability to track participants progress (ex: physical activity, weight, etc.) which must be reported to the CDC to maintain recognition status. How can you take advantage of this opportunity? Because these codes do not have to be linked to a specific type of organization or healthcare provider, you can use these codes in a variety of settings as long as the patient meets eligibility criteria. You could contract with a provider to offer these services to a groups of patients on a rolling basis. In a retail setting, you could offer group classes. As a pharmapreneur you can start a class in your community or develop online content for your audience. Really, with this one, the sky is the limit as long as you can meet the CDC criteria and track outcomes. Another huge benefit of this is that the enrollment is a minimum of 1 year, which allows you to track and monitor your patient outcomes long term. The next opportunity we'll discuss is remote patient monitoring. Sign up for the Pharmapreneur Community Newsletter and get it delivered directly to your Inbox! ABOUT THE AUTHOR: Amy Henneman, PharmD, BCACP, BCPS, CDE is an associate professor of pharmacy practice living in south Florida with her husband and two children. Her practice has been focused in building ambulatory care services and working to provide expanded care to low income patients. She enjoys working with both providers and other pharmacists to assist them in offering expanded pharmacy services. 
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Definition
Medicare covers a yearly appointment to discuss your plan of preventive care in the coming year. This appointment is called the Annual Wellness Visit (AWV). The Annual Wellness Visit is similar to the one-time Welcome to Medicare preventive visit but has important differences. For example, like the Welcome to Medicare visit, the Annual Wellness Visit (Initial Preventative Physical Examination) is not a head-to-toe physical. However, you cannot receive your Annual Wellness Visit within the first year you are enrolled in Medicare or within the same year you have your Welcome to Medicare exam. CPT Codes G0438 - Initial AWW - includes a personalized prevention plan of service (PPPS) G0439 - Subsequent AWV - updates a personalized prevention plan of service (PPPS) Components Initial AWV
Components Subsequent AWV
Opportunities for additional preventative services
Provider can bill for G0506 in addition to the AWV/IPPE billing Comprehensive assessment of and care planning by the physician or other qualified health care professional for patients requiring chronic care management services (billed separately from monthly care management services and MAY BE ADDED TO AN AWV- but must be seen by a QHCP). The G0506 code is particularly appropriate when the CCM initiating visit is a less complex visit (such as a level 2 or 3 E/M visit). G0506 can be billed along with higher level E&M visits if the practitioner’s effort and time exceeded the usual effort described in the initial visit E&M code. G0506 can also be billed when the initiating E&M visit addresses problems unrelated to Chronic Care Management and the CCM related work is not included in the initial visit code. Could be face-to-face and/or non-face-to-face, but the time spent doing the CCM care planning must not already be reflected in the CCM initiating visit itself or in the time spent during the monthly CCM (i.e., in CPT 99490, CPT 99487, CPT 99489) G0506 is meant to be billed only once per beneficiary during the initiation of the patient into Chronic Care Management. What services are you implementing in 2019? Leave me a note in the comments or join our Pharmapreneur Community Newsletter and email me directly! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. 
Would you like to watch a video version of this post? I've got you covered! Chronic Care Management Services Medicare is rewarding new processes aimed at improving patient care and reducing healthcare expenses. One new program that became eligible for physician reimbursement is a program intended to monitor certain patients with multiple chronic conditions. As of January 1, 2015, Medicare is paying for a non-face-to-face care coordination service through use of billing code 99490. The Chronic Care Management Services may be provided by phone or tele-health by a qualified health care professional under the physician’s general supervision. The service is usually offered as a 20 minute contact once every calendar month. An estimation provided by this CCM calculator shows that just 50 enrolled patients could equate to an additional $25,560 in revenue for the practice each year. This is a relatively new program that an entrepreneurial pharmacist could easily implement for multiple physician groups in their area for a fee. Eligibility Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline Comprehensive care plan established, implemented, revised, or monitored CMS requires the billing practitioner to furnish one of the following. Prior to billing the CCM service, and to initiate the CCM service as part Patient Agreement of this visit/exam.
12 Components of CCM
CPT Codes The two key differentiators between 99487 and 99490 are the additional time (60 minutes for CPT 99487 from 20 minutes for CPT 99490) and the requirement around medical decision making. In addition, a code reimbursing for additional time (CPT 99489) is available for complex CCM patients being billed under CPT 99487. Provider can bill for G0506 in addition to the AWV/IPPE billing Comprehensive assessment of and care planning by the physician or other qualified health care professional for patients requiring chronic care management services (billed separately from monthly care management services and MAY BE ADDED TO AN AWV- but must be seen by a QHCP) The G0506 code is particularly appropriate when the CCM initiating visit is a less complex visit (such as a level 2 or 3 E/M visit). G0506 can be billed along with higher level E&M visits if the practitioner’s effort and time exceeded the usual effort described in the initial visit E&M code. G0506 can also be billed when the initiating E&M visit addresses problems unrelated to Chronic Care Management and the CCM related work is not included in the initial visit code. Could be face-to-face and/or non-face-to-face, but the time spent doing the CCM care planning must not already be reflected in the CCM initiating visit itself or in the time spent during the monthly CCM (i.e., in CPT 99490, CPT 99487, CPT 99489) G0506 is meant to be billed only once per beneficiary during the initiation of the patient into Chronic Care Management. What do are your thoughts? Would this be a viable business model in your area? Leave a comment below. Leave me a note in the comments or join our Pharmapreneur Community Newsletter and email me directly! ABOUT THE AUTHOR: Blair Green Thielemier, PharmD is an independent consultant pharmacist living in Arkansas with her husband and two children. Her latest project is the host and producer of pharmacy’s first virtual conference, the Elevate Pharmacy Virtual Summit in partnership with the NCPA Innovation Center. She is the founder of Pharmapreneur Academy, an online e-Course and Community where she guides pharmacist-entrepreneurs through the process and barriers of building a pharmacy consulting business. She is the author of How to Build a Pharmacy Consulting Business and facilitates in-person Business Planning Workshops and Mastermind Retreats for female Pharmapreneurs across the country. More information about Dr. Thielemier can be found on her website. |
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