3 Reasons Why Pharmacy Revenue Cycle Is Struggling

We recently had Prochant infusion expert Jon Love provide an overview of the 2022 National Home Infusion Association (NHIA) Annual Conference. He was able to pinpoint three areas in particular that explain why pharmacy revenue cycle is struggling. As the nation’s leading reimbursement firm with a dedicated focus on pharmacy and HME, Prochant understands the problems providers face.

Talking with infusion providers from all around the country at the NHIA conference and on a weekly basis, Jon said the pain points infusion providers currently have are due to “a lack of expertise and broken processes, bad technology, and a lack of labor on the U.S. side.”


Problem #1: Lack of expertise and broken processes

Infusion providers’ main focus is taking care of patients and providing quality care. When it comes to reimbursement and structured outreach processes, it’s not always in a staff members’ wheelhouse.

“Every week, I talk to someone who's losing hundreds of thousands or millions of dollars, because they've come to this belief that they can't collect 95% of their expected revenue. They're getting 80%, meaning 15% of their revenue is being left on the table,” Jon told us. 


Prochant has over 30 years of experience in infusion pharmacy reimbursement and can implement a custom reimbursement strategy for you. Our client-average DSO is 35 and below, while most infusion providers we speak with have DSOs at 66 and 60. 

Keeping up with processes and interactions is hard. Prochant can help you receive a cash to net revenue result of 95% and a DSO below 50 days. With our expertise, your claims will be guided through the process and ensure each one gets billed accurately, on-time, and with all the documents needed.

Get in touch with us to learn about how our experts can simplify your business and offer support.


Problem #2: Bad technology

To have revenue cycle success, you need to have technology involved. “We can't work in spreadsheets anymore. We have to work in a place where we're tracking both our work and your work, and we know where our errors are and we can fix our errors quickly,” Jon said.

Even when providers have a system in place that should be keeping track of unpaid claims, old systems and manually updating spreadsheets can lead to errors and missed revenue. Seek out a platform to help keep track of your metrics that matter.


Platforms like our new revenue cycle intelligence tool, Prochant Analytics, are designed for quickly managing your processes. Its HITRUST-security certification protects your patient data and it comes with a Prochant expert client support team. Read the white paper or schedule a free demo here to learn more about this tool.


Problem #3: Lack of labor

Due to the COVID-19 pandemic, the push for home care and home infusion has become greater than ever before. People have realized they don't have to wait in a waiting room, they can be comfortable in their homes and get quality care without any added hassle. They don't want to go back to facilities to receive care.

While this can be good business for home infusion providers, the industry is also facing high turnover rate and an inability to properly train new staff in time. Losing a staff member now is critical. “It'll take you 18 months to train someone else, or it'll take you six months to get someone who knows what they're doing,” Jon said.

On top of the problem of retaining or training new staff, there is also the struggle with labor cost. “You're going to have to overpay them, because they know there are very few people out there.”


Running an in-house team isn’t easy or always affordable. That’s why Prochant offers an End-to-End Revenue Cycle Management solution that allows you to outsource your entire back office or Focused Solutions that let our team become a seamless extension of yours. 

“We're going to bring a global hybrid workforce of U.S. managers and global teams, so that we can staff appropriately. We're going to base it all on technology that's going to track and keep us all accountable, and give you transparency as you work with us. That's how we solve everything.”

To learn more about Prochant’s solutions for infusion, contact Jon Love at jlove@prochant.com or visit our pharmacy reimbursement solutions page here.


Prochant has a proven track record of helping HME and pharmacy providers meet their financial goals. Our scalable solutions, years of experience, and advanced technology provide best-in-class results to the healthcare community. Headquartered in Charlotte, North Carolina, our client base includes national HME and pharmacy providers and health systems.