Wiki buy and bill

[boogie9483]

Hi Guys,

I need to know what's the difference between "buy and bill" and sending a prescription to a pharmacy to fill a drug order and deliver it to the office for the provider to administer as a patient supplied drug. Does anyone know why a practice would buy and bill instead of the other option?

Thanks!

 

[CodingKing]

If its a high volume drug for the practice buying in bulk may increase profit margin. Especially if you can get discount for paying cash vs on account.

 

[alinton01]

Buy and Bill

The term "buy and bill" refers to a provider purchasing the medication from an FDA approved, reputable source and then supplying the (typically) medication along with the service. The other option is to give the patient a prescription (if the medication CAN be purchased by the patient) or send a script to a specialty pharmacy. The medication is often shipped to the provider's office to be administered to THAT patient only. The plus side to buy and bill-always have stock on hand, no waiting. Down side-waiting on insurance payment (after you have paid for the medication), insurance could deny or pay less than the cost. The plus side to sending the script out-the patient deals with the pharmacy over payment, leaving you out of it. Why you choose one over the other-for the reasons above OR some medications are only available under one option. For example, some medications are covered under Medicare Part B benefits and would be denied under Part D drug coverage so it wouldn't be an option to give the patient a script or send a script to a specialty pharmacy.