I have been tasked with an analysis on insurance reimbursements for injectable drugs given at our Primary Care office.
I knew there were a lot that were being reimbursed below cost, but I cannot believe how bad it actually is! We are losing so much money it is ridiculous.
What concerns me is that in most cases, 4 out of the 5 insurance payors analyzed are reimbursing below cost. How could they all be such crappy payers? I have been trying to no avail to find some list of the ASP for these drugs so I can get to the bottom of where the real problem is. The CDC posts a list of the private sector costs per dose of vaccines and that was very helpful for me in the past when I did vaccine analysis, but now I am stumped on the drugs......
Our worst discrepancies are with:
J1080 - Testosterone
J7321 - Hyalgan
J2920 - Solumedrol
Does anyone out there have any insight as to how I might be able to get the information I need? Does anyone have similar experiences?
I thank you in advance for any advice/info.
Have a splendiferous day!![Big grin :D :D](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
I knew there were a lot that were being reimbursed below cost, but I cannot believe how bad it actually is! We are losing so much money it is ridiculous.
What concerns me is that in most cases, 4 out of the 5 insurance payors analyzed are reimbursing below cost. How could they all be such crappy payers? I have been trying to no avail to find some list of the ASP for these drugs so I can get to the bottom of where the real problem is. The CDC posts a list of the private sector costs per dose of vaccines and that was very helpful for me in the past when I did vaccine analysis, but now I am stumped on the drugs......
Our worst discrepancies are with:
J1080 - Testosterone
J7321 - Hyalgan
J2920 - Solumedrol
Does anyone out there have any insight as to how I might be able to get the information I need? Does anyone have similar experiences?
I thank you in advance for any advice/info.
Have a splendiferous day!