Virtual FRM Support Reduces Open A/R Cases 42% in the Buy-and-Bill Channel

SCENARIO AND SERVICE

A manufacturer distributing through the buy-and-bill channel saw J-code reimbursement outcomes in hospital outpatient department (HOPD) and ambulatory surgery center (ASC) settings that were affecting sales and leaving cases with open accounts receivable (A/R).

PRO’s virtual field reimbursement managers (FRMs) provided reimbursement education to site-of-care staff. Each site learned about the coding, coverage, and payment requirements specific to its setting, so teams could better understand how claims for the product are processed.

GRAPHIC

CONCLUSION

Within two years of implementing the client support strategy, cases with open A/R fell 42%, while paid cases increased 429%. Clear, setting-specific reimbursement education helps sites of care understand each step of the J-code payment process. Learn more about our Revenue Cycle Management and virtual FRM services.