CarePoint Partners realizes that the reimbursement function is intrinsically linked to the clinical function and must be accomplished with equal competence and professionalism in order to provide optimal care to our patient community. With so many payer sources, each with its own set of rules for providers like CarePoint Partners, home infusion reimbursement is often confusing. The medications that we deliver and the varying treatment settings involved in home infusion therapy create reimbursement challenges.
Well, enter the CarePoint Partners’ reimbursement specialists. They are skilled at accumulating information, expressing information in a format that the payer will accept, and obtaining payment – a benefit to the patient, payer and provider.
To be successful at the reimbursement process, we’ve integrated our entire home infusion business: intake, sales/marketing, clinical staff, delivery and distribution, billing management and follow-up. Further, CarePoint Partners reimbursement professionals have the detailed knowledge and skill sets to address legal matters, accounting issues, and the clinical aspects of care. They communicate effectively with pharmacists and other clinical staff in order to effectively file and resolve claims as well as to put into place operational procedures that aid in the appropriate and timely collection of information and documentation critical to the reimbursement cycle.
Verifying benefits, a critical aspect of reimbursement, can take us from a few minutes to several days, depending on the payer and the therapy. We find some therapies are more complex to qualify and some payers are less familiar with home infusion services. Many insurance plans (and some state Medicaid plans) also require us to obtain prior authorizations before care can be provided.
Whatever the situation, the CarePoint Partners reimbursement specialists can put together the best possible solution for patient, payer and provider.