InfusionRevenue Recovery

Revenue recovered is profit realized. 

Billing methods that returned significant profit just five years ago have been squeezed to single digit profit margins since then.

Infusion therapy in non-hospital environments has taken a huge hit from Medicare, and it is still being targeted for further cuts.  Trying to stay current with reimbursement as well as quarterly drug price changes is a full-time job.  Knowing exactly what can be claimed, when and how is not always clear.

Additionally, according to The Department of Health and Human Services, their Medicare Fraud Strike Force efforts have identified over $300 million in infusion therapy fraud (http://www.stopmedicarefraud.gov).  The Strike Force has targeted large and small medical practices/centers/hospitals as well as medical manufacturers   (http://www.stopmedicarefraud.gov/innews/breakingnews.html). 

OCI’s proprietary Infusion Revenue Recovery™ (IRR) provides the most thorough review of all your data and charts available as well as stringent verification analysis in a risk-free contingency-based service.  We have confidence in the results we present to you. 

  • The process accounts for the regulatory and drug price changes that are hard to keep up with on an ongoing basis. 
  • The algorithms also verify infusion therapy drug cabinet data with actual codes that are billed out.

The benefits of Revenue Recovery are numerous:

  • From a profit standpoint, an under-payment is your money sitting there unclaimed. 

  • You’ve earned it, but regulation changes have made it more complicated than it used to be to claim it. 

  • On the flip side, overbilling is very common due to confusion with coding schedules and drug bundling among other oversights. 

  • One small error on some drugs can take 50 infusions to make up for in expenses.

OCI’s IRR process meticulously examines your organization’s medical records to find over and under reimbursements as well as highlighting areas where small changes on the front end can result in greater payouts on the back end.  You may be working 50 times harder than you need to.  OCI can help!

All of the Infusion Revenue Recovery™ data mining and verification processes we do carries no upfront costs; we work on a contingency basis, so it is to our benefit as much as it is to yours to ensure that all appropriate claims are organized and prepared in a timely enough manner to maximize return.  For that reason, we are motivated to make sure that we uncover all revenue opportunities and complete all details necessary to achieve that goal.  The result is a risk-free turnkey operation that will present a finished product ready for billing at completion.  Minimal time is needed from your staff.

In addition to maximizing profits, Infusion Revenue Recovery™ aids your organization in attaining compliance with changing insurance regulations.  Simply continuing processes and submitting claims the way it used to be done is often following incorrect procedures today.  It is possible to have a profitable oncology practice while still being compliant.  IRR provides OCI with the tools to recognize over-payments and recommend process alternatives that are profitable while maintaining compliance with insurance rules and regulations.  Finally, it is to your benefit to discover where your organization has been overpaid before RAC auditors do it for you.  Should they find those errors, repayment and fines may be in your future.

Please select our CONTACT US tab for more information on how Infusion Revenue Recovery™ can maximize your medical oncology practice revenue.