Pharmacists Can Shift to Provider Status With Medical Billing

In this episode of Medical Billing Decoded, clinical pharmacist Jennifer Griffin, PharmD, and regional pharmacy supervisor Duane Jones, BSPharm, explain how pharmacists can successfully transition from a traditional dispensing role to functioning as true healthcare providers through medical billing and structured clinical workflows.

They begin by reframing the pharmacist’s identity: pharmacy school trained them in pharmacology, therapeutics, patient interaction, and chronic disease management, not just prescription verification. With a national physician shortage and pharmacies located within 5 miles of most Americans, pharmacists are uniquely positioned to expand access to care through test-and-treat services, medication therapy management (MTM), and chronic disease consultations.

Griffin and Jones share how Harps Food Stores built a decade-long clinical workflow, starting with immunizations, then MTM, and later test-and-treat for conditions like strep and flu. A key tactic was dedicating technician time each day to clinical duties and treating MTM opportunities like prescriptions to normalize clinical workflow inside the pharmacy.

They emphasize that pharmacists have the education and expertise—often more years of training than other mid-level prescribers—and that pharmacist-led care closely follows evidence-based protocols, improving safety and outcomes. By billing for services historically given away for free, pharmacies can demonstrate value to health plans, improve patient outcomes, and generate sustainable revenue.

The episode also tackles common concerns about patient acceptance of costs. Griffin explains that patients already expect to pay for medical services, and many value the convenience and trusted relationship with their local pharmacist enough to pay cash rather than travel further for a free visit.

“We know that pharmacists have the knowledge to provide these services,” Griffin said. “We need to shift our mindset to thinking more like a provider, and so next step is we need to bill and charge like a provider and not be afraid to ask for what our services are worth.”