Medical infusion therapy lounges are becoming an increasingly popular addition to healthcare facilities, offering patients a comfortable environment for IV therapy under medical supervision.
Doctors and patients alike appreciate infusion therapy’s ability to deliver medications directly into the bloodstream, ensuring rapid treatment, often quicker symptom relief, and improved patient outcomes.
At Remy Healthcare, we specialize in partnering with healthcare clinics to establish and maintain quality infusion lounges using our extensive network and 340B program experience to make quality care more accessible and help practices thrive.
After several years in the medical field, Remy Sales Director (and Registered Nurse), Eugene Dinkelis has helped practice owners improve patient outcomes with 340B Pharmacies and Infusion therapies. Here are the 13 most common inquiries he gets from practices interested in adding infusion therapy lounges.
FAQ 1: These Infusion Therapy medicines are often not approved. Does Remy handle prior authorizations?
Yes, Remy handles all prior authorizations, ensuring that your clinic can focus on providing quality care to patients.
Prior authorizations can be incredibly labor-intensive, requiring detailed paperwork and consistent follow-up with insurance providers. We’re experts in navigating the complexities involved in getting medications approved for infusion therapy, especially those considered high-cost.
We manage all aspects of the prior authorization process, from initial submission to approval, using our expertise to navigate insurance requirements efficiently. By handling the administrative tasks, we ensure patients receive medications promptly, without added stress on your existing administrative or medical staff.
FAQ 2: When Remy evaluates the Electronic Health Record, are they looking for codes or prescriptions?
Yes. Initially, Remy focuses on diagnostic (dx) codes when evaluating your Electronic Health Records (EHR) to create a pro forma.
Diagnostic codes provide a comprehensive understanding of your unique patient population and the need for infusion therapies, helping us identify patterns and determine the feasibility and financial impact of setting up an infusion lounge in your facility.
Once we have an agreement, our Nurse Practitioner conducts an in-depth review of patient charts to identify potential treatment opportunities. This involves reviewing diagnostic codes and relevant prescriptions to capture a complete picture of patient needs.
As partners, our role is to support your physicians and provide them with additional resources and potential treatment options, not to dictate how they should practice medicine – your physicians always retain full control over treatment decisions.
FAQ 3: What time period does Remy use to validate the need for an Infusion Clinic?
We conduct an analysis based on patient data from the previous 6-12 months. This data forms the basis of our pro forma, a detailed financial projection that helps you understand the potential return on investment and operational impact of the infusion clinic.
Focusing on a 6-12 month period allows us to accurately assess trends in patient diagnoses, treatment patterns, and potential demand for infusion services, identifying consistent needs and predicting future utilization of the infusion clinic.
FAQ 4: Is this covered under an FQHC’s FTCA malpractice?
Yes, the infusion of drugs is covered under an FQHC’s Federal Tort Claims Act (FTCA) malpractice coverage.
The FTCA protects FQHCs and their employees from certain medical malpractice claims. As long as the person performing the infusion is acting within the scope of their employment and services provided fall within the approved scope of the FQHC’s practice, infusion therapy is considered part of general primary medical care, and the infusions are covered by FTCA malpractice protection.
This coverage means that if a claim arises from administering infusion services, the federal government steps in as the primary insurer, providing significant liability protection to the health center and its staff.
While this is a necessary protection for providers, it’s crucial to note that all procedures and treatments must adhere to the guidelines and scope defined by the FTCA to ensure coverage. Remy’s experienced team of compliance experts ensures our partners can focus on delivering high-quality care, without the burden of excessive liability risk.
FAQ 5: Is additional insurance needed?
Not likely. Additional insurance is only required for services that fall outside the standard scope of operations as defined under your existing coverage, typically referred to as gap insurance.
Gap insurance provides a safety net for services that go beyond the usual scope of your operations, covering liabilities or risks that are not covered under existing insurance policies or the Federal Tort Claims Act (FTCA) malpractice coverage. Establishing what constitutes ‘in-scope’ versus ‘out-of-scope’ activities is crucial in determining the need for additional insurance to maintain compliance and financial stability while expanding services.
For example, if your Federally Qualified Health Center (FQHC) decides to expand services to include oncology infusions—a specialty not originally within the defined scope of your practice- hiring an oncologist to write infusion orders for such treatments would require the FQHC to purchase gap insurance.
FAQ 6: Is Infusion Therapy considered an “additional service” by HRSA?
No. In most states, infusing a drug is not considered an additional service by the Health Resources and Services Administration (HRSA).
The HRSA recognizes infusion therapy as within the scope of services that FQHCs are authorized to provide in most states, provided it aligns with the overall healthcare services being offered to the community. This classification helps ensure that patients receive seamless care under the FQHC’s umbrella without needing additional approvals or modifications in service scopes.
“From managing prior authorizations and evaluating EHRs to understanding insurance and staffing requirements, at Remy we demystify everything 340B and infusion-related. Whether you’re concerned about compliance, patient coverage, or operational logistics, we’ve got you covered”. –Eugene Dinkelis
FAQ 7: Who do the staff work for?
Staff provided by Remy, specifically the registered nurse (RN), will be employed directly by Remy Healthcare.
Although the nurse is an employee of Remy, their daily responsibilities will be carried out within your facility, focusing on providing high-quality coordination and infusion services to your patients.
This arrangement allows your clinic to benefit from the expertise of Remy’s specialized healthcare staff without the complexities of direct employment, so you can avoid the administrative burden associated with hiring, training, and managing additional staff.
The result is infusion services are seamlessly integrated into your existing healthcare offerings, enhancing your capacity to deliver comprehensive care while maintaining continuity with other medical services you offer.
FAQ 8: Do you have problems recruiting Spanish-speaking staff?
No. Because we recognize the importance of addressing the linguistic and cultural needs of the diverse patient populations served by our partner facilities, we prioritize the recruitment of bilingual registered nurses (RNs) fluent in both Spanish and English.
We have established a robust recruitment process that targets bilingual professionals, especially in communities where there is a high demand for Spanish-speaking medical staff. This proactive recruitment strategy helps avoid potential issues in staffing bilingual personnel and ensures our services are accessible to all patients, regardless of their primary language.
Remy’s inclusive approach ensures that all patients receive care that is not just effective, but also culturally sensitive, easy to understand and navigate, and compliant with federal requirements for language access in healthcare settings.
FAQ 9: Does the infusion clinic need to be in the same location as the 340B pharmacy?
No. The infusion clinic does not need to be in the same physical location as the 340B pharmacy, but it must be situated within the in-scope space of the Federally Qualified Health Center (FQHC).
The key compliance requirement is that the infusion suite operates under the umbrella of the FQHC’s main facility and adheres to the health center’s 340B eligibility and compliance guidelines.
This integration facilitates streamlined operations, maintains compliance with federal regulations, and optimizes patient care by making necessary treatments more accessible and cost-effective.
FAQ 10: Who is responsible for managing phones, scheduling, inventory, and billing?
Remy Healthcare takes full responsibility for managing all operational aspects related to the infusion suite, including handling phone communications, scheduling appointments, managing inventory, and overseeing billing processes.
By centralizing these administrative operations under Remy’s management, we ensure infusion lounges are seamlessly integrated into your existing practice. Our experienced team custom tailors specialized systems and protocols to produce a bespoke solution that optimizes efficiency and accuracy in each of these areas while ensuring compliance and your total control over patient treatment.
For example, our scheduling system is tailored to manage patient appointments to avoid overlaps and ensure that each patient receives timely treatment.
Our inventory management ensures that all necessary medications and supplies are always available, preventing delays.
Our billing practices fully comply with healthcare regulations, ensuring all services are billed correctly to minimize errors and facilitate timely insurance reimbursement.
This full-spectrum management by Remy enhances operational efficiency and improves patient satisfaction by providing a smooth and organized treatment experience. As your partners, we aim to allow you to focus on providing great patient care, not the administrative tasks associated with it.
FAQ 11: What about uninsured Patients?
Thanks to our extensive experience in the 340B arena, Remy offers an unprecedented range of solutions to help uninsured patients.
The Remy team actively works to ensure uninsured patients have access to necessary infusion therapies by helping them register for free drug programs offered by pharmaceutical manufacturers. These programs are designed to assist patients who do not have health insurance or who are underinsured, providing them with critical medications at no cost. This is particularly important in managing chronic conditions where consistent medication administration is crucial.
Additionally, for clinics not already enrolled in the 340B program, Remy can help determine eligibility and coordinate enrollment and continued compliance in the program.
Our approach involves a thorough assessment of each patient’s eligibility for these programs based on the manufacturers’ criteria. Then, we assist in completing and submitting all necessary applications and documentation, helping to mitigate the financial and administrative barriers associated with infusion drugs while ensuring all patients receive the care they need.
We’re proud of our proactive efforts to assist uninsured patients, underscoring our commitment to champion inclusive care and support for all patients, regardless of their financial circumstances.
FAQ 12: Does Remy only offer drugs, or do you also do fluids and electrolytes?
While our primary focus is on administering prescription drugs through infusion therapy, we also offer the administration of fluids and electrolytes as part of our comprehensive service offerings.
This includes treatments such as hydration therapy, which is helpful for patients suffering from dehydration, electrolyte imbalances, or needing supportive care in various medical conditions. Offering both drug infusions and electrolyte treatments allows partners to meet a broader range of patient needs, providing a versatile and comprehensive infusion service. This dual capability enhances the overall care experience, ensuring that patients receive the necessary treatments efficiently and conveniently in one location.
While drug infusion services are often covered under insurance or through the 340B program, fluids and electrolyte infusion is not covered by most insurances and is a cash-based service (paid out-of-pocket by the patient). We ensure that all potential costs are transparently communicated to patients and their caregivers beforehand to help them make informed decisions about their care options.
FAQ 13: Is chemotherapy included?
Remy Healthcare specializes in the administration of biologic therapies rather than chemotherapy. While chemotherapy is a critical component of cancer treatment, it involves the use of chemical substances to stop cancer cells from dividing and growing and is not part of the services provided by Remy.
Biologics are advanced medicinal products often derived from living organisms, and used to treat various conditions such as autoimmune diseases, inflammatory disorders, and some types of cancer. These treatments include monoclonal antibodies and other types of protein-based therapies, which are administered via infusion.
Our focus on biologics allows us to concentrate on a specialized area of infusion therapy that supports patients with chronic diseases in managing their conditions effectively. This specialization ensures that our staff are highly skilled and knowledgeable in the latest advancements and protocols related to biologic therapies, providing the highest level of care and expertise to our patients.
What’s Next?
As the demand for specialized infusion therapies continues to grow, understanding the logistics and benefits of setting up an infusion clinic within your healthcare facility becomes paramount.
Remy Healthcare is dedicated to assisting Federally Qualified Health Centers (FQHCs) and other medical providers in enhancing their service offerings through expertly managed infusion lounges and 340B program registration and compliance.
With our comprehensive support in handling everything from prior authorizations to marketing, Remy ensures that your facility can deliver high-quality care without the administrative burden.
Whether you are exploring the addition of infusion services or seeking to optimize your existing operations, our team of experts guides you every step of the way. Our tailored approach doesn’t just meet the specific needs of your patient population, but is designed to align with your practice goals, ensuring a seamless integration and operational excellence.
Take the first step towards transforming your patient care services today.
Contact Eugene to schedule a free consultation and receive a customized pro forma. This no-obligation consultation will provide you with all the necessary information to make an informed decision about integrating an infusion clinic into your healthcare practice. Let us help you enhance your patient care capabilities and expand your services to meet the growing needs of your community.