Reimbursement & Financial Insights

Community physician practices strive to balance running a lucrative business with providing excellent care. Besse Medical understands this challenge and strives to provide expert knowledge on the financial and reimbursement aspects of the buy-and-bill business. We offer services and technologies that can help practices make smarter buying decisions, improve reimbursement efficiencies and reduce administrative burdens. We understand the importance of maintaining a healthy cash flow inside a practice and we offer the guidance and resources to support success.

The current Medicare reimbursement methodology for Part B drugs administered in physician offices and hospital outpatient departments is based on a drug’s Average Sales Price (ASP), as reported by drug manufacturers to the Centers for Medicare and Medicaid Services (CMS). ASP is a market-based price that reflects the weighted average of all manufacturer sales prices and includes all rebates and discounts that are privately negotiated between manufacturers and purchasers (with the exception of Medicaid and certain federal discounts and rebates).

This website lists ASP information for certain drugs. This information is obtained CMS on a quarterly basis, and may or may not reflect the current ASP listing maintained by CMS. Customers are encouraged to consult CMS directly for the most accurate listing of ASP.  See https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/index.
 

We believe in a proactive approach. For example:

  • ensuring practices have immediate, no-hassle access to their contract pricing through GPO networks as well as product pricing programs offered by the manufacturers
  • alerting practices to changes in usage that could affect rebates or future pricing on a product
  • reminders to take advantage of discount buying or pre-order opportunities to maintain the best price on every order
  • notifying a practice of fluctuating terms on a high-dollar pharmaceutical that could cause a cash crunch later in the year
  • communicating terms changes, pricing program changes and coding changes at the earliest possible moment
  • offering resources to help during transitions like ICD-9 to ICD-10
  • credit analysts trained to listen for reimbursement issues and expedite these directly to the manufacturer for assistance
  • providing quick reference to coding and reimbursement assistance for every pharmaceutical
  • access to reporting that shows current CMS drug reimbursement data for the quarter

The online practice management tools on besse.com allow practices to access real-time pricing, rebate and tiered pricing structures, reimbursement and coding reference tools, payment and credit options and sophisticated reporting and payment resources.
 

Here are some guidance materials: