Assignment of Benefits for Buy and Bill Product

Looking to gain some insight on successful methods of hubs to gain access for buy and bill product via assignment of benefits with SP. Unfortunately, my hub experience tells me they are not good as pursuing options on behalf of patients and prescribers. Do some of you have success with hubs managing AOB process?

 

sure. Anyone else thinking that it's a bit odd that someone with a detailed question such as this is not qualified to network directly and obtain this specific info?

 

The obvious thing to do would be spend time talking to a lot of hubs and their references....but I am not smart enough to post questions on CP

 

the coding is cumbersome and SPs do not want to put personnel and man power to support

 

Actually, the answer to this question is that hubs cannot take assignment on 'buy and bill' drugs because Medicare is a major payer. Out of the hospital setting, Medicare only allows non-self-administered drugs to be billed 'incident to' a physicians' service, meaning it can only be billed by the prescribing provider or their practice. While SP's often do take assignment on these claims, the legality of this is questionable as they are billing these drugs to Part D, which supposedly does not cover 'buy and bill'.

 

Medicare does not allow for assignment of benefits ever. Only the buyer can administer it and bill for it. And that needs to be an M.D. Period.

 

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