What is buy and bill?

Buy and bill is a practice in which healthcare providers purchase medications directly from a manufacturer or wholesaler and then bill a patient's insurance for reimbursement. This is commonly used for specialty drugs that are administered in a medical office or clinic setting.

In buy and bill arrangements, the healthcare provider takes on the financial risk of purchasing the medication upfront before being reimbursed by the insurance company. They are responsible for managing inventory, storage, and handling of the medication, as well as ensuring appropriate billing and coding to maximize reimbursement.

Buy and bill can be a complex process and requires careful coordination between the healthcare provider, the patient, the insurance company, and the drug manufacturer. It is important for healthcare providers to stay informed about changes in reimbursement rates, coding guidelines, and drug availability to effectively navigate the buy and bill process.