Revenue Streams

Revenue Streams for Physician Dispensing

Physician dispensing, or the provision of medications directly to patients at the point of care, is becoming an increasingly popular practice model in many healthcare settings. While the primary objective is to improve patient care, it also offers the potential for generating revenue. Understanding the revenue streams associated with physician dispensing can help practices optimize their financial management while delivering quality care.

Patient Cash & Carry

WHAT IS IT?

This method involves patients directly purchasing their medications from the physician at the time of their visit, paying the full amount in cash or via other direct payment methods.

BENEFITS

Immediate Payment

Physicians receive instant compensation for the medications, eliminating the wait for insurance claims or third-party reimbursements.

Simplified Transaction

By avoiding the insurance billing process, administrative burdens are reduced.

Flexibility

Practices can set competitive prices based on patient demographics, medication types, and other factors, potentially attracting more patients.

Private Insurance Reimbursement

WHAT IS IT?

In this model, physicians submit claims to private insurance providers to seek reimbursement for the medications they dispense.

BENEFITS

Broader Patient Base

Accepting private insurance can make services accessible to a larger pool of patients who rely on their insurance for medication costs.

Predictable Revenue

With established reimbursement rates, physicians can anticipate revenue based on the number and type of prescriptions dispensed.

Value-added Service:

Some insurance plans may offer higher reimbursement rates for value-added services, such as medication therapy management, allowing practices to generate additional revenue.

Worker’s Compensation

WHAT IS IT?

Workers’ compensation is a form of insurance that provides wage replacement and medical benefits to employees injured in the course of employment. Physicians can dispense medications relevant to these injuries and seek reimbursement from workers’ compensation insurance.

BENEFITS

Specialized Care Opportunity

Dispensing for workers’ compensation cases allows physicians to cater to a specialized market with unique needs.

Timely Reimbursements

Workers’ compensation often has stipulated timelines for reimbursement, ensuring practices receive payments in a predictable manner.

Higher Reimbursement Rates

Often, WC reimbursement rats can be more favorable than other insurance rates, especially for specific injuries or conditions.

EXPLORING THESE REVENUE STREAMS 

Exploring these revenue streams allows practices to diversify their income sources, improve cash flow, and enhance their financial stability. It’s essential, however, to manage these streams efficiently, ensuring compliance with regulations, maintaining transparency in billing, and continuously assessing the profitability and sustainability of each revenue source. By doing so, practices can ensure they maximize both patient care and revenue generation from physician dispensing.