Why is a 340B Referral Program Important?

May 10, 2022

Nuvem clients have the option to include our Advanced Referral Program to their 340B Program, but why is this addition valuable? When it comes to an end-to-end referral program with dedicated Referral Coordinators assigned to clients, the only possible outcomes are benefits to your program’s savings, functionality, and organization.

  1. The average additional savings for every captured 340B eligible referral claim is $400, maximizing your program while maintaining compliance. When our Referral Coordinators work as an extension of your organization, we are also able to obtain greater than 85% of all documentation requests. We mine the data you provide us, contacting your referral specialists, obtaining care notes, uploading that information to the portal, all resulting in significant additional savings.
  2. Referral programs have the potential to bring in exponentially more revenue for your pharmacies. One client shared that one center had 14 sites making equal to what their 340B program was bringing in with our referral program in place. Another shared that in terms of gross profit, our referral program is bringing in 18% of their program’s total revenue. The numbers don’t lie!
  3. Our Referral Coordinators work very closely with Covered Entities to define and administer your program. To ensure that claims are 340B eligible, we make sure to understand your organization’s specific policies and procedures around referrals and 340B while we act as an extension of your Covered Entity.
  4. We believe complete information and record keeping is key, therefore all documentation and files are uploaded and stored in our system for each referral. Maintaining information for each provider allows our team to act smarter, easily retrieve claims documentation, and prepare for audits. This information also provides better direction for our Referral Coordinators.
  5. Our referral program’s SMART technology identifies 340B referral claims, ensuring we get the correct referrals right away and can focus on prescriptions that are truly eligible referrals. Sophisticated algorithms are utilized to mine all claims data determining potentially eligible referrals, providing you lists of potentially eligible claims for our Referral Coordinators to work toward. This allows each Covered Entity to set their individual Referral Policies, ensuring only claims meeting these requirements are captured.
  6. Ease-of-use and portal functionality is a priority, so we provide our Referral Coordinators real-time access to information to get a complete view of each patient when mining data. Providing full access enables our team to make better-informed decisions and focus on highest value prescriptions.
  7. Our 340B consulting experts, will audit your referral program on a monthly basis. This means not only are you getting a full-service referral program, but also a monthly audit to maintain compliance and ensure captured prescriptions truly meet the definition of a referral prescription based on your specific policies and procedures.

According to a client, “My greatest lesson learned is that Nuvem is masterful at their implementation and personable in their approach. That referral program was the icing on the top, and as we grow our percentages in specialty scripts, it will potentially be the deal maker, the gift that keeps on giving…Do it right away, I wouldn’t wait a minute. There’s no reason to wait four months when you can make money right away.”

See for yourself here, or contact us today.

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