5 Warnings Signs for Infusion Pharmacy Billing

Once bad habits are created, they can be difficult to break. Our webinar below covers the five warning signs your infusion pharmacy revenue cycle management is costing you revenue, as well as what you can do to change it. Prochant’s Pharmacy Reimbursement Manager, Tina Ratliff, broke down how to identify and fix the five most costly bad habits in the industry. 

Warning Sign #1: Unnecessary Manual Processes With Existing Software

  • Take the time to learn how to optimize the software you use. This will prevent your business from making tasks more difficult than they need to be.
  • Calculate drug units using software, not by hand. The manual approach can lead to overbilling and underbilling unbeknownst to the provider.
  • Set up your system to automate processes. One of the main advantages associated with automation is it prevents human error. When providers reduce human errors, their claims start to pay significantly better.

Warning Sign #2: Copying Previous Claims

  • Make sure you start fresh each time.
  • Copying previous claims makes it too easy to create a mistake when billing units.
  • A new claim may contain new or updated data that differs from the previous claim.

Warning Sign #3: Overbooking Revenue

  • Utilize the fee system in your software to load your contracts. This ensures your prices are as accurate as possible since they represent your expected revenue. 
  • Use best claim correction practices to avoid duplicating revenue.
  • Proper processes prevent creating false expectations surrounding revenue.

Warning Sign #4: Missing Information in the System

  • Evaluate your billing office to identify which parts of the process are being typed manually. 
  • Load contracts into a decentralized system that is accessible to all parties.
  • Eliminate paper charts to prevent human error. 
  • Ensure a uniform system of processes, that way all parties will have access to the latest information.

Warning Sign #5: Following Outdated Guidelines

  • Outdated practices can lead to unnecessary complications in your process.
  • Follow up on payer changes to guarantee they’re following the latest terms and processes.
  • Date system notes so you can detect old information. Whenever you add a note to your system, make sure to initial and date it.
  • Ban the phrase, “That’s the way we’ve always done it.” Processes should be viewed through an unbiased lens when it comes to maximizing efficiency. 

The sooner a company is aware of its bad habits, the sooner it can start correcting them. Listen to the full webinar to hear all of Tina’s tips on identifying and reversing issues relating to the infusion pharmacy revenue cycle below:


Prochant has a proven track record of helping pharmacy and HME 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 pharmacy and HME providers and health systems.