The home infusion industry represents an estimated $9 billion to $11 billion of all healthcare expenditures, due in large part to the growing number of patients who administer intravenous or infused medications at home.
Additionally, because the cost associated with home infusion therapy is typically $150 to $200 per day, compared to $1,500 to $2,000 per day for an inpatient admission, the home infusion industry continues to experience rapid growth as many private insurers recognize the potential for savings and provide full coverage for home infusion therapy.
The Solution
Leveraging more than 15 years of home infusion contract compliance auditing and consulting, Viant has developed the Beech Street Home Infusion Network, a best-in-class, national network of the six largest home infusion providers, along with numerous regional home infusion companies. The Beech Street Home Infusion Network is a unique and comprehensive solution that audits and re-prices claims accurately on 100% of all home infusion claims to exact contract terms, before the claim is paid. This unique specialty network helps our customers accurately manage and control the high costs associated with reimbursement of home infusion provider services.
How it Works
We conduct a unique pre-payment audit of physician orders to validate accurate and appropriate units of high-cost specialty pharmaceuticals infused or injected in the home setting. Viant pharmacy auditors, experienced in specialty pharmaceutical dosage and administration, validate actual physician orders, perform exact pharmaceutical calculations, reconcile correct product and package sizes of high-cost drugs billed and reprice claims to current competitive reimbursement levels for these specialty services. Drug reimbursement is based on the most cost-effective drug and packaging regardless of what is billed, and our ability to expedite accurate payment to providers enables us to secure deeper discounts for our clients. The average savings for our Home Infusion Network is currently 67%. The network can replace existing direct contracts or secondary networks, reducing reimbursement, provider abrasion and unnecessary administrative rework. Advantages
- Clinical staff review of physician treatment plans ensures correct billing
- Comprehensive billing review ensures accurate payment to providers
- Definitive contract language ensures that providers use cost-effective product and package size when dispensing physician orders
Summary
Beech Street's Home Infusion Network enables payers to realize significant savings by providing in-home drug therapy that would otherwise cost exponentially more in an inpatient setting. Leveraging our years of experience in contract compliance and specialty pharmaceutical audits, the Beech Street Home Infusion Network enables our customers to manage and control the high costs associated with reimbursement of home infusion provider services.
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