A fair visit value for an infusion center’s referral sales team
A growing multi-site infusion center group was moving its referral sales team to Salesforce. Drug contracts, distributors, and specialty-pharmacy visits made the value of a visit swing widely, and a planned billing change was about to remove claims and margin data from its WeInfuse reporting. Greyfield designed one report that gives every administered visit the same yardstick.
billing units per administered visit, by J-code
JW units counted and priced at public CMS ASP
valued, including specialty-pharmacy visits
SalesforceAt a glance
The challenge
Reps were credited for infusions they generated, but drug contracts, distributors, and specialty-pharmacy visits made value per visit inconsistent. Some visits brought the center no drug margin at all. A planned move of billing out of the infusion EHR would also remove claims and margin data from its Looker reporting, so any value built on that data would break.
What Greyfield did
Map the order-centric model to Salesforce
Walked the implementer through the EHR’s order-centric model and mapped referring practices, physicians, patients, and orders to Salesforce objects. Copied the reports the old CRM already consumed into a dedicated folder so they could be repointed rather than rebuilt.
Define a visit that counts
A visit counts only when the appointment is completed and drug was administered. A check-in with no drug given is not billable and gets no credit.
Build one units report
Summed billing units of the primary drug per administered visit by HCPCS code, waste lines included. Grouping by code instead of NDC collapsed vial-size duplicates to one row per visit, primary insurance only kept secondary claims from doubling units, and removing an expected-payment filter brought specialty-pharmacy visits back in.
Price units at public ASP in Salesforce
Salesforce multiplies the units by CMS ASP rates. Loading historical quarterly ASP lets history be back-calculated, so trends hold through the billing change.
What changed for the client
The visit-value report is live in the folder the CRM integration reads, and the implementer took over the pipeline build. Every administered visit, including specialty-pharmacy visits, now carries a value that doesn’t depend on claims data staying in the EHR. What we’d do differently: confirm the patient-identifier key with the implementer on day one. WeInfuse is a trademark of its owner; Greyfield Data is independent.
billing units per administered visit, by J-code
JW units counted and priced at public CMS ASP
valued, including specialty-pharmacy visits
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