Prudent Referral Source

We all want to grow our business and naturally a steady stream of prescription opportunities bolsters that goal. One must always assume that if something looks too good to be true it probably is. There are very important things to consider when receiving referrals from brokers for compounded prescriptions.

The reason for the selectivity of how you get your leads is simple. You are ultimately responsible for the script that goes out and therefore the buck stops with you. You must ask your brokers how they get their leads and more importantly what their relationships are with their sources. Be very careful that a prescribing physician does not have a direct business relationship with the broker. As an example, if there is an orthopedist that is a partner, stock holder in a mutual business or closely business related to the broker this presents certainly the appearance of potential kick-back violations. You will certainly be part of the ensuing investigation when that happens.

Look at the prescriptions and examine handwriting, names and other attributes that are important to recognize when filling a script. Also, examine records to make sure that the patient has seen the prescribing physician; not investigating this is a common error and can cause delays or denial of payments. To solidify the validity of the scripts you are receiving, call the patient, verify the script, prescribing physician, the date that the patient saw the doctor and perhaps the mailing address information.

This seems to be counterproductive to growing ones business if one questions the business source and the patients. However, penalties for collusion, kick backs and unauthorized fulfillment of prescriptions can generate audits by the carriers or the PBM’s and ultimately close down you business.

Many compounding pharmacies using factoring are being helped, in that the factor when underwriting these transaction, examines these items and will catch any of these tell-tale signs. Xynergy Healthcare Capital specialized is healthcare factoring and works closely with compounding pharmacies providing cash flow solutions.