Infusion Reimbursement: 3 Tips for Success

Home infusion billing doesn’t have to be complicated – just ask our experts.

The infusion pharmacy market continues to grow. However, this growth brings challenges to billing teams. From intake to cash posting, pharmacies see their share of revenue cycle issues. So, how can they better manage their infusion reimbursement?

We turned to the experts. Jon Love, Prochant’s VP of Business Development, and Tina Ratliff, Prochant’s Pharmacy Reimbursement Manager, provide important insights below.

1. Don’t rush the intake process.

The intake process takes time. When billers are overwhelmed, they may miss or enter incorrect information. For example, your team might fail to verify a patient’s benefits or get prior authorization. In addition, they may enter incorrect information such as date of birth, diagnosis, or insurance ID numbers. You might also find unsigned delivery tickets that require signatures for Medicare.

2. Keep track of your forms.

Missing forms cause delays in the pharmacy revenue cycle. So, to keep your team running smoothly, you need to ensure that they complete the following forms:

  • Assignment of benefits (AOBs)
  • DME information forms (DIFs)

Additionally, home infusion billers need to have proper documentation for claims processing. Updated prescriptions and medical records will keep your team on track, too.

3. Watch out for billing errors.

Mistakes happen! Yet, you need to prepare for common billing errors. Some issues include:

  • Incorrectly coded items
  • Improperly calculated billing units
  • Incorrectly added modifiers

Your team might face other challenges. For instance, billers may bill the wrong payer or set up a billing system incorrectly.

Next week, Jon and Tina will share more tips for infusion reimbursement success. Contact us today to learn more about our pharmacy solutions.

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Prochant is the only AI-driven reimbursement service provider in the home-based care industry. We deliver focused revenue cycle management (RCM) solutions to healthcare providers with 7 wholly-owned global delivery centers. Our expertise lies in providing end-to-end RCM for home-based care, infusion, and specialty pharmacies, consistently delivering exceptional results to some of the leading healthcare providers in the country. We harness specialized automation technology and deep industry knowledge to streamline the time-consuming and expensive reimbursement process. As a result, we help healthcare providers accelerate their collections, increase revenue, and reduce operational costs while managing risk. Prochant is HITRUST certified, the gold standard for HIPAA security.