Pharmacy Revenue Cycle Solutions

At SunStone, our clients keep coming back, year after year. That’s because we help them see that risk and reward in the pharmacy revenue cycle are not polar opposites.

Whether you are a stand-alone hospital or part of a health system, a complete and accurate pharmacy revenue cycle is essential for capturing both the cost and revenue attributable to pharmaceuticals.

We have assisted clients with large-scale pharmacy revenue cycle standardizations involving multiple pharmacy information systems, and we help them with ongoing maintenance and updates. Without consistent attention to the complexities involved in the pharmacy revenue cycle, providers experience a loss in net revenue, especially for chemotherapeutics, injectable drugs and high-tech biological agents.

Regardless if it’s a full-scale standardization, or a yearly update, we evaluate if all the costs for each drug dispensed are recognized in the final price, as well as ensure that the HCPCS, revenue codes, and units are appropriately captured on the claim.

Another vital component is to ensure compliance with the new waste modifier that was effective January 1, 2017 (Modifier JW).  We can help make sure you successfully implemented a process that is consistent with the JW requirements.

An integral part of our process is flow-charting drugs as they move through your hospital, including the various information systems; and collaboratively working with pharmacy and revenue cycle teams to design efficient processes, ensure appropriate pricing, and maximize compliance and revenue. In fact, we have helped our clients gain an average of 8% in pharmacy net revenue.  At the same time, our clients enjoy knowing that pharmacy prices are fair, transparent, and defensible.

We can offer these benefits because our professionals have an in-depth understanding of the complexities within the pharmacy revenue cycle processes, including National Drug Codes (NDC), Wholesale Acquisition Costs (WAC’s), HCPCS, revenue codes, units, and all the complex pricing mechanisms inherent within Pharmacy Information Systems.


Our clients have enjoyed revenue opportunities ranging from $300,000 to over $2 million annually. They have also engaged us for additional services and maintenance solutions, and have recommended our services to their peers.


Our Pharmacy Revenue Cycle Solutions are often provided in tandem with a Charge Description Master or Pricing Solution.


Vonda K. Moon, M.S.

Kristie Bailey, MPA, COC