During a time of change and uncertainty that is often synonymous with the healthcare industry, strategies that cut costs without compromising quality of care are highly sought after by all third-party payers. Site of Care (SOC) Optimization is one of the top proven strategies for reducing the cost of specialty biologic medications. A SOC optimization strategy encourages patients to move from higher-cost settings, like big hospitals and institutions, to lower-cost settings, such as physician’s in-office infusion suites or stand-alone Infusion Centers. Insurance companies and Medicare have been moving forward with SOC optimization policies that are driving patients out of the hospital setting. Unfortunately, they are at the same time, creating policies that discourage physicians and infusion centers from expanding their infusion services. […] Read more
About Bryan Johnson
Entries by Bryan Johnson
If you have been following our WeInfuse IV Insights Blog for a while, then you are already familiar with our previous articles about billing for infusion and injectable products in the physician’s in-office infusion suite and in stand-alone Infusion Centers. If you have not already, be sure to review our previous blog entries before moving on. Start with Billing for Infusion Time – “The Confusion of Infusion Billing” then HCPCS Billing for Medications – “Billing Infusion Medications” as pre-requisites to this guide.
For this article, I will use the term “infusion billing” to generically describe billing for any injectable product – infusion (IV), […] Read more
Listen to our recently launched WeInfuse Infusion Center Podcast series to hear interviews from infusion suite and Infusion Center industry experts. Learn how some of the leading infusion practices and companies are innovating and thriving in today’s’ complex healthcare environment. Hear sound advice, tips, and tricks from experienced industry executives and practice managers who are working to provide patient access to this critical medication delivery model.
The WeInfuse Podcast also features interviews with key representatives who are providing solutions to the infusion market including distributors, product vendors, manufacturers and other technology offerings.
You can listen to the WeInfuse Podcast FREE on our Podbean channel, […] Read more
For the practice-based infusion suites and stand-alone Infusion Centers, keeping patients compliant with their treatment schedules results in better clinical outcomes and improves the financial health of their business models. While treatment compliance is important with traditional oral medications or therapeutic injectables, it is paramount with specialty injectables and IVIG therapies.
Specialty medications, including biologics and IVIG, carry a substantially higher cost than traditional therapeutic injectables. These medications mostly treat patients with Chronic Autoimmune Diseases who require frequent, interval-based treatments. The combination of high cost and chronic repeated interval scheduling raises the stakes for practices who manage these medications in the […] Read more
Next to quantum theory, I would put infusion and infusion billing in a close second place for complexity. I recently published an article around billing for infusion procedures in an attempt to simplify some of the confusion. If you missed my first installment The Confusion of Infusion Billing, it’s worth going back and taking a quick glance to understand where I am coming from.
If you have mastered infusion administration billing, then you are ready to move on to billing for the infusion and injection medications themselves. While not a walk in the park, I find that billing for the medication […] Read more
I have been in and around medical billing for over 15 years in various practices and ambulatory healthcare services, and I would never tell anyone that medical billing is a simple or logical process. However, with some practical study and a little experience, anyone can eventually learn the nuances of full-revenue cycle medical billing for most medical services.
Having said that, infusion billing continues to frustrate me even after many years of study and experience. I have personally overseen $100+ million of infusion and specialty injection claims, and still I have to be very careful to slow down when explaining the […] Read more
As a common guy and macho father of 2 young boys, I tend to have an “instructions optional” attitude about putting together new kid toys and the boxed furniture my beautiful bride brings home from IKEA. One of the few times I actually did read the instructions, I ended up with extra parts in my hand and had to watch in horror as my hastily assembled TV stand came crashing down with the new 50″ HD set on top. Fortunately for our clients and their patients, I have quite the opposite approach when it comes to infusion orders and our […] Read more
Based on overwhelming feedback on our original Blog Post – Considerations for Opening an In-Office Infusion Center, we decided to reboot the original article and re-post it here with some minor edits. We are continuing to help new and existing Infusion Centers open and improve across the country. If you have ever considered opening or expanding your own in-office Infusion Center or Infusion Suite, take a moment to read below.
If you are a physician-based practice and have been thinking about opening an in-office Infusion Center (aka Infusion Suite) for your patients, we wrote this post especially for you. Creating an […] Read more
Its the most wonderful time of the year! …unless you are in charge of ordering infusion medication and medical supplies for your patients. 🙂
This is a courtesy reminder to all of our blog readers that normal expectations for medication and medical supply deliveries should be moderated to include delays caused by increased holiday shipping. For those offices who like to run their “just-in-time” inventory at one-day to same-day availability, we would advise them to consider increasing their days on hand of inventory an extra day or two in consideration of these expected delays.
Black Friday, Amazon, the start of winter weather […] Read more
You may find it surprising that there is a $100+ billion dollar healthcare delivery model that you have never heard of. That’s right, “Billion” with a “B”. Unless you or someone you know has a rare chronic disease, you likely have never heard of this amazing (and expensive) group of specialty biologic medications delivered primarily by intravenous infusion or injection through non-oncology Infusion Centers and Infusion Suites.
Even if you have never heard the term: “autoimmune disease” (AD for short), you likely are familiar with Multiple Sclerosis, Crohn’s Disease, Lupus, Rheumatoid Arthritis, and Psoriasis. It’s less likely you have heard of […] Read more