WASHINGTON — In spite of poor Medicare reimbursement, infusion therapy can still be profitable, Steven M. Coplon said at a conference sponsored by Elsevier Oncology.
Under Medicare's reimbursement system for infusion drugs, “essential services are underreimbursed or not reimbursed,” said Mr. Coplon, chief executive officer of The West Clinic, a Memphis, Tenn., oncology practice. “But the cost of drugs, staff, facilities, and malpractice insurance all continue to increase.”
Practices have to look more closely at the revenue they are getting for their services, Mr. Coplon said. For example, “on one drug regimen [given frequently to Medicare patients], we're making $24 on $7,061 worth of investment.”
One way to increase revenue is to increase the amount the practice brings in from private payers, he continued.
“Negotiate it to the best of your ability; go for every code you can possibly think of,” he advised. “If they're willing to say yes, you can make up for a lot of these margins you're losing on Medicare.”
Roberta L. Buell, vice president of provider services and reimbursement at P4 Healthcare, Sausalito, Calif., encouraged optimal billing procedures: “80% of receivables should be less than 90 days overdue,” said Ms. Buell. “And if your practice is more than 50% Medicare, you should be doing much better than that.”
Elsevier Oncology and this news organization are wholly owned subsidiaries of Elsevier.