Corinthian Health Services Blog

Blog for Corinthian Health Services

Archives for November 2017

IVIG Purchase Reimbursement – Everything You Need to Know

A steady and sustainable stream of revenue is integral to the health of any practice. And often, revenue hinges on the ability to secure timely reimbursements, especially for expensive products like IVIG. If you’re like most physicians, you know all too well how challenging IVIG purchase reimbursement can be.IVIG Purchase Reimbursement

From payment denials to nuanced processes, unsuccessful IVIG purchase reimbursement efforts can hurt your bottom line. To ensure speedy and accurate IVIG purchase reimbursement, you must be well-versed in MACs, relevant codes, and reimbursement files.

What are Medicare Administrative Contractors (MACs)?

Acquiring an in-depth understanding of the role and function of a Medicare Administrative Contractor (MAC) is critical to managing your practice’s or center’s IVIG purchase reimbursements. MACs essentially acts as intermediaries between healthcare facilities and Centers for Medicare and Medicaid Services (CMS). All financial transactions are submitted by healthcare facilities to MACs to be processed for payment. MACs perform a host of time-sensitive and critical tasks including:

  • Submitting and accounting for Medicare FFS payments
  • Processing, Medicare FFS claims
  • Enrolling providers in the Medicare FFS program
  • Managing provider reimbursement services and provider cost reports
  • Overseeing and responding to redetermination requests (first stage appeals process)
  • Responding to provider inquiries and teaching providers about Medicare FFS billing requirements
  • Establishing and communicating local coverage determinations (LCD’s)
  • Reviewing medical records relevant to specific claims
  • Coordinating and communicating with CMS and additional FFS contractors

As you can see, MACs play an essential and decisive role in IVIG reimbursement and process over 1.2 billion Medicare FFS claims each year.

Using the Right Codes

The importance of using the right medical codes when it comes to submitting an IVIG purchase reimbursement claim is often underestimated. Precise medical coding is significant on many levels, among the most notable being its role in helping to maintain accurate patient records reflecting the treatment, care, and medications administered. Proper medical codes are also necessary to guarantee correct payment to physicians for services rendered. Failure to reference the right code may lead to delay or even denial of payment.

Medical coding is a complex and specialized asset for all healthcare organizations, regardless of size or patient population.  Simply put, coding is the operational channel between coverage and payment. To ensure favorable and expeditious IVIG purchase reimbursement outcomes, you should employ an experienced medical coding service provider with a proven track record of quality and accuracy.

Estimating Your Reimbursement

When it comes to reimbursement, the only constant is change. In other words, reimbursement for the physician office and hospital outpatient facilities changes all the time. CMS provides reimbursement based on the Average Sales Price (ASP), which is calculated using manufacturer sales data. With fluctuating market conditions, new products emerging, and price shifts, it’s not surprising that reimbursement for some medication increases, while it decreases for others.

In addition to reviewing informative and updated resources such as CMS’s quarterly reimbursement drug file or ASP guides provided by the U.S. Department of Health & Human Resources, you need a trusted partner to answer your questions and ensure that you get the reimbursement that you deserve.

With so many factors to consider and effectively manage with ROI in mind. As a provider of this service, w,  contact us today to learn more. It’s not what you’re paying; it’s what you’re getting paid.

 

IV Infusion Companies – Your Guide to Finding the Best

The best IV infusion companies provide cost-effective infrastructure and high-quality patient care. As the demand for IVIV Infusion Companies infusion centers continues to grow, many physicians are clamoring to find the best company to collaborate with amid a seemingly endless list of options. Finding the best company to help you launch and sustain a successful IV infusion center requires research and careful vetting. The first step is identifying the pillars of service that ensure patient satisfaction and operational success.

Finding the Best IV Infusion Companies

Exceptional Patient Care. Let’s face it – high caliber patient care is paramount.  The first deliverable you should look for in IV infusion companies is how they play a role in staffing. Generally, physicians are bogged down with hiring, training, and paying their own clinicians in a self-managed model. Top notch IV infusion companies will provide clinically superior RN’s to staff the infusion center and administer care. Additionally, you want to partner with a company who provides personnel for sick and vacation coverage, guaranteeing that your center will always be fully staffed.

Care for your Practice. Feeling overwhelmed by the administrative demands of managing a practice? Superior IV infusion companies allow you to focus solely on your patients as they absorb the center’s core operational functions including:

  • Furnishing and instituting all policies and procedures for liability coverage
  • Providing RN case managers for precertification and authorization to ensure collections, sparing you the need to find and train an employee to oversee and document these critical transactions
  • Delivering all components of Human Resources with the cost being included in the management fee, as opposed to you incurring the ongoing exorbitant costs
  • Capitalizing on its large provider status and strong collective bargaining power to negotiate cost-effective terms with vendors and better J-codes and infusion codes on your behalf
  • Sharing clinical liability while boasting a lawsuit-free record, relieving the physician of assuming all liability
  • Producing detailed monthly financial reports for review, exempting the practice from additional accounting fees

Contemporary Products and Services.  A key trait to look for when finding the best IV infusion companies is their proven reputation for being up-to-date on the latest infusion therapy practices and state-of-the-art services. It’s important to collaborate with a company who regularly monitors and assesses potential products and payor contracts to ensure that the center is not only providing optimal care for its patients but also achieving financial success in the process.

No Hassle Billing. Additionally, the best IV infusion companies take pride in managing all time-sensitive and complex financial elements such as paying vendors within 15 days and monitoring and reconciling all bills and claims to achieve nearly debt-free standing. As all physicians in a busy practice know, time seldom permits for the persistent efforts needed to track and resolve problem claims. As a result, the profitability and overall health of the practice suffers. Only the best IV infusion company can remedy this common challenge and propel a practice to come out ahead.

Why Your Patients Deserve More

Your patients have enough on their plates. Between the financial and emotional adversity that they often face, coupled with the tedious and overwhelming nature of paperwork, billing, and endless appointments, they deserve only the best when it comes to care. Partnering with an esteemed IV infusion company will allow you to provide a positive and comfortable healthcare experience for your patients and their families.

If you are actively searching for the best IV infusion companies with whom to do business, look no further. Our turnkey solution eliminates the hassle and headache of starting from scratch by providing all the operational, staffing, and financial components needed to get started. If you already have an infusion center established and would like us to see if we can get you lower costs per gram and meet your unique needs, contact us today to learn more.