In its fourth year, the Resident Project of the Year Award was created to recognize the excellent work our residents do in their residency projects. Preceptors were able to nominate their residents' project and include a justification of why the project should win the award. From there, each nomination was reviewed and awarded by the Residency Advisory Committee. The winner was recognized during the graduation ceremony.
Sierrah Althaus, PharmD
Nominated by: Kati Dvorak at Welia Health
“Optimizing Ambulatory
Pharmacy Billing in a Rural
Health System”
“Sierrah’s residency project, “Optimizing Ambulatory Pharmacy Billing in a Rural Health System,” has had a profound and lasting impact on our organization. As many in the field are aware, billing for Medication Therapy Management (MTM) services—and securing appropriate reimbursement—can be a complex and often frustrating challenge. While larger health systems typically have dedicated billing and support staff manage coding, credentialing, and data analysis, smaller rural systems like Welia, often lack the resources and infrastructure to support this work. As a result, billing for MTM services is frequently not understood or executed appropriately. Sierrah’s project sought to address these gaps by conducting a comprehensive review of Welia’s current MTM billing processes. Her objectives included identifying major payers for MTM services at Welia Health, understanding the most common causes of claim denials, evaluating reimbursement trends based on proper use of Current Procedural Terminology (CPT) codes, and highlighting opportunities for growth and improvement. She analyzed data across three different software platforms to determine which system provided the most accurate and actionable billing insights. Through her review, she was able to pinpoint both payer trends and the most frequent denial reasons. Sierrah took the crucial first step in a long-needed process, enabling us to better analyze our data, identify key payers, and strategically focus future efforts. Her project has positioned us to advance our MTM services and pursue more effective, accurate reimbursement.” - Kati Dvorak