Timely Filing & Collections: What You Need to Know

Improve your infusion pharmacy reimbursement with these quick tips.

Your specialty pharmacy is made of many moving pieces and parts. With a long list of reimbursement challenges, you might lack the necessary resources to quickly file claims and collect money. How can you fix this issue? Our home infusion billing experts, Jon Love and Tina Ratliff, have you covered. Let's look at what you need to know for timely filing and collections in your pharmacy.  

The Timely Filing Problem 

Why do timely filing and collections often fail? It's a major problem for pharmacies, but one that's rarely talked about. Our experts have identified three common reasons: 

  • Poor processes: The pharmacy revenue cycle thrives on proper processes. When there are delays in filing claims, the entire revenue cycle suffers and backlogs build quickly. 
  • Poor follow-up: Billers need to consistently follow up on claims. When their follow-up falls behind, you risk losing money from payers.
  • Lack of resources: Short-staffed teams are stressed and stretched thin. In turn, productivity dips as timely filing falls on the priority list. 

Correcting Timely Filing

How can you turn your filing around? Our experts recommend the following actions.

  • Electronic primary claims
  • Secondary claims
  • Paper claims

Correcting Timely Collections

There are also ways to improve your collections.

  • Corrected claims
  • Medical records follow-up
  • Appeals follow-up

What Does Success Look Like?

When you implement our experts' suggestions, success is possible for your infusion pharmacy reimbursement. Let's look at the numbers.

  • Bad debt reduced to 3% or less
  • Cash-to-net revenue results of 97%+
  • DSO maintained or lowered to 50 days

To learn more about timely filing and collections and better manage your reimbursement, contact the infusion experts at Prochant today!