Analytics for home infusion providers
Intake, authorizations, referral follow-up, and getting paid: what carries over from clinic infusion, and what is different at home.
Where our experience comes from
Honest scope
We haven’t had a home infusion provider as a client yet; most of our infusion work has been with ambulatory infusion centers and the companies that receive their data.
Referrals, authorizations, denials, unbilled therapy, and partner feeds carry over. For nursing visits and per diem billing, we would study your data before promising anything.
What carries over from clinic infusion
These look almost the same whether the chair is in a center or a living room.
- 01Intake and referral follow-upEvery open referral by stage and age, so you see which are waiting on benefits, authorization, or a start date.
- 02Authorization trackingAuthorizations ending soon, matched to the next delivery or nursing visit, so renewals happen before a therapy gap.
- 03Referral source reportingReferrals and starts by referring provider and facility, so liaisons see where volume comes from.
- 04Revenue cycle reportingUnbilled therapy, denials by reason and payer, and A/R by age, from your billing and remittance files.
- 05Partner data feedsFeeds for manufacturers, hubs, or payers with a written grain and checks before each send.
What is different at home
Ignore these and the numbers look fine but mean the wrong thing.
- 01Nursing visits happen away from the pharmacyA dispense, a delivery, and a nursing visit are three events, so reports keep them apart and link them by patient and therapy.
- 02Billing is often per diem plus drugMany payers pay a per diem for services and supplies with the drug billed separately, so revenue reports keep those lines apart.
- 03Payer mix matters moreCommercial plans and Medicare cover home infusion differently, so report revenue and denials by payer from the start.
Metrics we would set up
A starting list, confirmed against how your system records each event before we build it.
| Metric | What it measures | Watch for |
|---|---|---|
| Referral to start of therapy | Days from referral received to the first dose given at home. | Split by stage. A delivery delay and an authorization delay need different fixes. |
| Referral conversion | Share of referrals that start therapy, with a reason for each one that doesn’t. | Hospital discharge referrals can expire fast. Track their age by the hour or day. |
| Expiring authorizations | Active patients whose authorization ends within 7, 14, or 30 days. | Compare against the next scheduled delivery, not just the calendar. |
| Missed or moved nursing visits | Nursing visits missed or rescheduled, divided by visits planned. | Keep patient-driven and staffing-driven changes apart. |
| Dispensed vs administered | Doses dispensed compared with doses documented as given. | They won’t match row for row. Match on patient, therapy, and a date window. |
| Unbilled therapy days | Days of therapy delivered with no claim yet, by age. | Per diem and drug lines can be billed at different times. Track both. |
| Denial rate | Denied claims or dollars divided by submitted, by reason, payer, and therapy. | Needs remittance (835) data from your billing system or clearinghouse. |
Our closest proven work
Feed and integration work for infusion providers and a hub-services company. Client names stay private.
Hub-services and patient-access company
Built a Python connector that pulls nine WeInfuse entity feeds per infusion center through the Looker API, with a runbook for onboarding new centers.
Read the case study
Multi-site ambulatory infusion provider
Built four manufacturer data-contract feeds in an infusion provider’s embedded Looker, with status and dispense reconciled and QA before every upload.
Read the case studyFree tools and guides
The calculators are built for clinics, but the referral leakage math works the same for home starts.
Calculators
Guides and white papers
- Manufacturer Programs Without the Manual ReportingFree white paper (PDF): what manufacturer and hub programs ask for, why files get sent back, and how to automate them.
- Referral to first treatmentWhere referrals stall before the first infusion, and how to measure each stall.
- Infusion denial analysisGroup denials by reason, payer, drug, and site to find the cause.
- Infusion revenue leakageEvery stage from order to deposit, what leaks at each, and what to measure.
More in the infusion analytics guides and free tools.
Common questions
Have you worked with home infusion providers before?
Not yet as a direct client. Our infusion work so far has been with ambulatory infusion centers, a hub-services company, and the data feeds infusion providers send to manufacturers. Intake, authorization, referral, revenue, and feed work carries over. Nursing visit and per diem reporting would start with a close look at how your system records them, and we will say which parts are new to us.
Why is our home infusion denial rate so high?
The cause usually sits upstream of billing: an authorization that lapsed, an eligibility change nobody caught, or documentation that doesn’t support the per diem or the drug units billed. Group denials by reason code, payer, and therapy before you change anything, so you fix the biggest cause first.
Which data do you need from us?
It depends on the first question. Intake and authorization reporting usually comes from your pharmacy or home infusion system. Revenue and denial reporting needs your billing system and remittance files. We start with whichever system holds the answer you need first.
Can you build data feeds to manufacturers or hubs?
Yes. Feed work is where our infusion experience is strongest. The main difference for home infusion is that a dispense and an administration are separate events, so the feed has to say which one each row is.
Will you sign a BAA?
Yes. We sign a business associate agreement before we access any PHI, and we use synthetic data for demos and examples.
Tell us where referrals or revenue go missing
Bring the report you can’t get today. We’ll tell you plainly whether it is work we have done before, and how we would approach it.
WeInfuse is a trademark of its owner. Greyfield Data is independent and not affiliated with WeInfuse.