Innovative Solutions for              Providers         who “Buy-and-Bill” for        High Cost Therapeuticswww.rxassure.n...
Definition of Terms“High Cost Therapeutics”     Expensive therapies with costs ranging from     $10,000 to over $150,000 f...
The Challenges of Buy-and-BillReimburseme     nt    Reimbursement uncertain with new drugs    Claims complexity and insura...
The RxAssure Solution                                   Expert RCM   Capital     RxAssureNet                              ...
RxAssure Client Promise“If the reimbursement for an RxAssure high cost therapeutic      is less than the RxAssure advance,...
RxAssure Addresses EachChallenge      Reimbursement     Cash FlowOperating Costs  Patient Care
Client Benefits√   Minimize accounts receivable√   Mitigate reimbursement risks√   Repurpose working capital√   Improve pr...
Getting Started√   Seamlessly integrates with existing practice    workflows√   No cost to enroll in the RxAssure program√...
RxAssure Program Guidelines   RxAssure does not take title of receivables nor accepts assignment of    claims.   Reimbur...
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RxAssure - Financial Protection for Buy-and-Bill Physicians

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RxAssure is an innovative solution that offsets the financial risks that medical practices face when they buy-and-bill for high cost therapeutics. The short presentation provides an introduction to the RxAssure solution and describes how it benefits medical practices and patient care.

learn more at www.rxassure.net or see a video at http://youtu.be/Om6Zsl_pyEg

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  • Hi, my name is michael lubin and I’d like to introduce you to RxAssure – an innovative solution that solves the challenges that medical practices face with the buy and bill process for high cost therapeutics.
  • Before we begin, let’s clarify a few key terms – When we say high cost therapeutics, we’re referring therapies administered by physicians in their practices for conditions like cancer or rheumatoid arthritis that can cost anywhere from about ten thousand to over one hundred and fifty thousand dollars per administration. When we say buy and bill we’re talking about the process in which a physician practice is required to purchase the drug upfront, typically from a distributor, and then seek reimbursement after the therapy has been administered.
  • The buy and bill process creates numerous challenges for medical practices that administer high cost therapeuticsIt creates reimbursement challenges- New drugs are particularly challenging given that insurance coverage can be limited and reimbursement rules can be unclear Claims submission can be onerous and complex, plus changing reimbursement rules can be hard to keep up withIt creates cash flow management challenges Reimbursement delays or claim denials can have devastating impacts on practice cash flow And managing cash between drug purchases and reimbursement can be hardOperating costs are effected Many practices hold cash in reserve to guard against potential claim delays or denials While others incur “cost of capital” expenses when they finance the purchase of high cost drugsPatient care is also impacted by the buy and bill process Many practices will cap the number of patients they’ll put on high cost therapies to limit financial exposure Some practices are forced to refer their patients to other doctors or facilities to avoid the financial risk
  • RxAssure is specifically designed to address each of the challenges created by the Buy and Billl process.The RxAssure Solution consists of three integrated elementsThe first is a capital advance that covers the cost of the drug, less patient co-pays and deductibles. RxAssure delivers the capital advance within three days of claim submission so clients are never out of pocket when it comes time to pay for the drug. THIS helps to protect cash flow.The second is RxAssureNet – our powerful, web-based automated revenue cycle management software solution. RxAssureNet is specifically designed to manage all aspects of the high cost therapeutic billing process. RxAssurNet contains a continuously updated rules engine that shows clients all the data fields and clinical documentation requirements needed to submit claims correctly. RxAssureNet takes the guess work out so clients submit clean claims every time.The third element is our Expert revenue cycle management support team. The RxAssure Support team works closely with clients, watching their work in RxAssureNet to ensure the right information is in place at the right time, alerting them when it’s not and ensuring everything is perfect prior to claims submission. They also take responsibility for prior authorizations, letters of medical necessity, claims appeal work and staying current on changing insurance rules.Together, RxAssureNet supported by our Expert team dramatically mitigates insurance reimbursement risks.
  • RxAssure goes one step further with our client promise – “if the reimbursement for an RxAssure high cost therapeutic is less than the RxAssure capital advance, the different will be covered by RxAssure.”
  • As you can see, the RxAssure Solution in combination with our Client Promise successfully addresses each of the challenges associated with the buy-and-bill process helping to protect practices against financial risks.
  • With RxAssure physicians can now Mitigate accounts receivableMinimize reimbursement risksRepurpose working capital Improve practice and billing office efficiencyDecrease practice operating costsExpand treatment options for patients
  • Getting started with RxAssure is simple:The RxAssure solution fits in seamlessly with your existing practice workflowsThere are no costs to enrollNo upfront feesAND No software feesAnd if you fit our Fast Trak criteria, we can have you using RxAssure within one weekCall us today to learn more or email us time that is convenient for you.Thank you for your interest in RxAssure.
  • There are specific program guidelines that are important for you to understand and that required in order for the program to be compliant:RxAssure does not take title of receivables nor accepts assignment of claims.Reimbursements are remitted directly to the physician.The physician is responsible for ordering and taking title to drug.The physician is responsible for collecting patient co-pay and deductible.RxAssure receives no financial support from manufacturers.RxAssure capital advance may be used to offset reimbursement shortfalls for drug charges only. Thank You
  • RxAssure - Financial Protection for Buy-and-Bill Physicians

    1. 1. Innovative Solutions for Providers who “Buy-and-Bill” for High Cost Therapeuticswww.rxassure.n Program Introduction et
    2. 2. Definition of Terms“High Cost Therapeutics” Expensive therapies with costs ranging from $10,000 to over $150,000 for conditions including cancer and rheumatoid arthritis.“Buy and Bill” The process in which a physician is requiredto purchase a high cost therapeutic and thenseek reimbursement after administration.
    3. 3. The Challenges of Buy-and-BillReimburseme nt Reimbursement uncertain with new drugs Claims complexity and insurance rule changes Cash Flow Claim delays and denials Managing distributor terms Operating Costs Capital reserve requirements in case of delays/denials Cost of capital to finance drug purchasesPatient Care “Capping” number of patients on certain drugs Losing patients to referring facilities Limiting therapeutic options
    4. 4. The RxAssure Solution Expert RCM Capital RxAssureNet Support Team AdvanceProtect Cash Flow Mitigate Reimbursement RiskMinimize AR
    5. 5. RxAssure Client Promise“If the reimbursement for an RxAssure high cost therapeutic is less than the RxAssure advance, the difference will be covered by RxAssure”
    6. 6. RxAssure Addresses EachChallenge Reimbursement Cash FlowOperating Costs Patient Care
    7. 7. Client Benefits√ Minimize accounts receivable√ Mitigate reimbursement risks√ Repurpose working capital√ Improve practice and billing office efficiency√ Decrease practice operating costs√ Expand treatment options for patients
    8. 8. Getting Started√ Seamlessly integrates with existing practice workflows√ No cost to enroll in the RxAssure program√ No upfront fees√ No software costs√ Fast Trak clients can be live in one week Call us today at (858)480-9437 to start the enrollment process or send us an email at info@rxassure.net to learn more.
    9. 9. RxAssure Program Guidelines RxAssure does not take title of receivables nor accepts assignment of claims. Reimbursements are remitted directly to the physician. The physician is responsible for ordering and taking title to drug. The physician is responsible for collecting patient co-pay and deductible. RxAssure receives no financial support from manufacturers. RxAssure capital advance may only be used to offset reimbursement shortfalls for drug charges.

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