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.
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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.