Why drug billing blind spots lead to missed revenue for practices
By Besse Medical
Specialty practices know that the ability to provide medication directly to patients while they’re in the office can improve patient compliance, enhances care coordination, and creates an additional revenue stream. But for many practices, drug billing is one of the most complex parts of revenue cycle management and it can be difficult to understand true drug margins across payers.
For many specialties, where high-cost drugs are common, even small billing discrepancies can result in significant revenue loss. Missing a single drug charge can mean tens of thousands of dollars in lost reimbursement.
InfoDive® from Cencora is a powerful business intelligence solution that provides transparency into drug costs and reimbursements. By integrating data from inventory management and billing systems, InfoDive compares what was dispensed with what was billed. This allows practices to identify discrepancies – such as drugs or units that were dispensed but not billed, or drugs or units with incorrect quantities billed – with associated dollar amounts.
Understanding reimbursement trends and detecting revenue gaps
InfoDive goes beyond many traditional billing reports by showing not only what a practice bills and receives for drugs, but the actual cost of those drugs – a critical insight for specialty practices. This level of transparency allows practices to pinpoint which payers may not be covering the true cost of medications and identify underpayments or missed payments that can be rebilled.
InfoDive also supports data-driven decision making around drug selection. Many treatments have multiple drug options, including biosimilars, that offer clinically appropriate alternatives at different price points. By comparing reimbursement, cost, and utilization across drugs used for the same treatment, practices can better evaluate which options support both high-quality care and sustainable margins.
Practices can:
- Break down drug billing and reimbursement by payer
- Monitor cost and reimbursement trends over time as drug prices increase
- Analyze performance by provider and location
- Identify drugs where reimbursement falls below acquisition cost
By finding blind spots in drug billing and reimbursement, and translating complex data into actionable insights, InfoDive helps practices better understand their true drug margins, close revenue gaps, and make informed decisions that support both patient care and financial performance.
Contact our team today at ProviderClientServices@intrinsiq.com to schedule your demo.
