What is Infusion Pharmacy Reimbursement?

Manage your pharmacy revenue cycle better with infusion pharmacy reimbursement.

Infusion pharmacies provide important services for patients needing prescriptions compounded or therapy administered via catheters or needles. From hemophilia to multiple sclerosis, these pharmacies treat a variety of difficult diseases. Their revenue cycles can be just as complex. That is why we are providing you with an overview of infusion pharmacy reimbursement, a suite of solutions that can help you to better manage your pharmacy revenue cycle.

The Pharmacy Revenue Cycle

You face many daily obstacles when operating an infusion pharmacy. Revenue cycle challenges, including payment for your services, are likely at the top of that list.

Let’s review the pharmacy revenue cycle so that we can better understand it.

The pharmacy revenue cycle contains many moving pieces and parts. From the time infusion pharmacies receive a referral, the clock is ticking to move patients smoothly through each process. However, you may face delays such as:

  • Old A/R getting older,
  • Challenging accounts or payers,
  • Lacking experienced insurance collectors,
  • Auditing concerns from Medicare or other payers, or
  • Needing another set of eyes to look at billing.

As your staff falls behind, you might also notice errors in your billing.

The Basics of Infusion Pharmacy Reimbursement

This is where infusion pharmacy reimbursement comes in.

Reimbursement solutions reduce DSO through clean and accurate billing. In addition, some solutions providers, including Prochant, offer audit preparation and review to ensure compliance with all applicable payers.

Ultimately, choosing infusion pharmacy reimbursement allows your staff to focus on the most critical elements of your business.

You typically have a couple of reimbursement options:

  • Full outsourcing: A team of experts fully manages your billing function.
  • Staff augmentation: Solutions for staffing or interim resource needs.

Reimbursement providers might also provide consulting solutions. These solutions may include analyses of your data and recommendations for performance improvement.