Pharmacy Bookkeeping Built Around What the PBM Actually Pays You
Booxmax is a bookkeeping, payroll, and advisory firm.
An independent pharmacy can fill a prescription, book the revenue, and learn weeks later that a fee pulled the margin back below zero. The only way to know what you actually made is to reconcile every remittance against what you dispensed, plan by plan. We keep those books.
[ Book a 20-minute remittance-and-margin check ]
The margin you booked is not the margin you keep
On a growing number of prescriptions, the reimbursement can come in below what the drug cost you to buy, and the fees that decide your real margin land after the sale, not at the register. Direct and indirect remuneration fees and retroactive clawbacks get assessed weeks or months later, so the profit you recorded at dispense can quietly turn into a loss on the books. The only way to see it is to reconcile each remittance against what you dispensed and pull your true margin by PBM, because one plan can pay you a few points while another pays you under water. We keep that reconciliation current, so you are managing real numbers instead of point-of-sale guesses.
Inventory is your largest asset, and it moves every day
Drug inventory is usually the biggest number on a pharmacy’s balance sheet, and it shifts constantly with purchasing, dispensing, shrinkage, and expiry. If cost of goods and inventory are not kept tight, your gross margin on the books is a guess, and the one number that tells you whether the business is healthy is the one you cannot trust. We keep cost of goods and inventory reconciled, so margin is a fact you can act on rather than a year-end surprise.
Front-end and clinical revenue do not behave like the pharmacy counter
The clinical services least exposed to PBM pressure, immunizations, medication therapy management, point-of-care testing, are billed outside the standard prescription claim, and front-end retail runs on its own margins and sales tax. Lumped together with prescription revenue, none of them tells you anything. We separate the prescription counter, the front-end, and clinical-service revenue, so you can see which parts of the store actually carry the margin.
What we keep, every month
- Third-party remittances reconciled by PBM, including the DIR and clawback adjustments that land after the sale.
- Cost of goods and drug inventory kept tight, with front-end retail and sales tax tracked separately.
- A/R on third-party and house-charge accounts, with aging on slow payers.
- Pharmacy payroll (pharmacists, technicians, clerks, and overtime tracked clean).
- Monthly reports in QuickBooks Online by Certified ProAdvisors.
We reconcile to your remittance totals, not the patient record
Bookkeeping works from financial and remittance data. Your patients’ prescription and health records stay in your pharmacy system, and we do not take them.
What we do, and what we don’t
We are a bookkeeping, payroll, and advisory firm. We do not submit or adjudicate claims, appeal a MAC price, bill the PBMs, prepare tax returns, or give legal advice. Claim submission and reimbursement disputes route to your pharmacy system and your PSAO or billing service. Income tax routes to your tax preparer. Patient and prescription records stay in your pharmacy system. We keep the financial numbers underneath all of it.
Local, secure, QuickBooks-based
Certified ProAdvisors who reconcile your third-party remittances, a secure 256-bit SSL/TLS client portal, based in Burbank and serving the LA metro.
[ Book a 20-minute remittance-and-margin check ]
FAQ
Can you tell us our real margin by PBM? Yes, reconciled through the fees that land after the sale, so you see margin as it actually settles rather than what the register showed at dispense. That tells you which contracts pay and which lose money on every fill.
Do you submit our claims or handle MAC appeals? No. Claim submission and reimbursement disputes route to your pharmacy system and your PSAO or billing service. We keep the books and reconcile what comes back.
Do you track inventory and front-end separately? Yes. Prescription cost of goods, drug inventory, and front-end retail with sales tax are kept distinct, because they behave nothing alike.
Do you handle our patients’ health information? No. Bookkeeping works from financial and remittance data only. Prescription records stay in your pharmacy system.
Are you local? Yes. Booxmax, Inc., Burbank, CA, serving the LA metro.
This page explains general bookkeeping mechanics. It is not legal or tax advice, and it is not claims billing or PBM-contract advice. Claim submission and reimbursement disputes route to your pharmacy system and PSAO; tax matters route to your tax preparer; patient records stay in your pharmacy system.
Booxmax, Inc. · 224 E Olive Ave, Ste 217, Burbank, CA 91502 · (818) 485-2669 · Info@booxmax.com · booxmax.com