Infusion center billing software that checks the claim against the documented time
Infusion center billing is the conversion of an infusion visit into administration and drug charges. Administration is time based, with an initial hour code and add on codes for each additional hour, and the drug is billed separately by units and wastage. Federal payment rules sit in 42 CFR Part 414 and coverage in 42 CFR Part 410, with hospital based infusion paid under the outpatient prospective payment system. Neurobird checks every charge against the documented start and stop times before the claim leaves.
Neurobird Infusion Center in short
- Tie infusion administration codes to documented start and stop times, not to estimates
- Track drug units and wastage against the vial actually used
- Watch authorization windows and unit limits before the patient is scheduled
- 42 CFR 414 Payment rules for Part B medical and other health services, the federal basis for how administration and drug charges are paid. eCFR, 42 CFR Part 414
- 42 CFR 410 Supplementary medical insurance benefits, which set what is covered in an outpatient setting before any question of payment amount arises. eCFR, 42 CFR Part 410
- Pricing runs 250 to 900 US dollars per month across 3 tiers. Early access is free.
What infusion centers and ambulatory infusion suites actually deal with
Why it stays broken
The clinical record, the authorization file and the charge sheet are 3 separate documents produced by 3 different people. The claim is assembled from all 3 several days later, by which point nobody can add a missing stop time to a note from last Tuesday.
On 240 visits a month, 15 claims short by one add on code is a quiet permanent leak.
An injection is typically a quick, single-dose administration, while an infusion is a slow, methodical drip that may last from minutes to several hours.
The visit, as your biller would check it
A working preview. Tick an item to validate it against the record.
| Line item | Amount | |
|---|---|---|
| J code units, wastage recorded | $1,840 | |
| Chair time 210 minutes, 1 chair | $620 | |
| Prior authorization expires in 21 days | $3,275 | |
| Visit 4412, 96365 first hour | $455 |
Click recover to add a missed line to the invoice.
Neurobird Infusion Center Revenue Recovery Platform
Check the charge against the record while the record can still be corrected. Time, units and authorization are the 3 things that decide the claim, so check exactly those.
- 1Tie infusion administration codes to documented start and stop times, not to estimates
- 2Track drug units and wastage against the vial actually used
- 3Watch authorization windows and unit limits before the patient is scheduled
- 4Reconcile chair time, nursing time and billed time so the schedule and the claim agree
What changes with Neurobird Infusion Center?
The same work, read left to right: how it runs today, and how it runs once the record is in one place.
| Today | With Neurobird Infusion Center |
|---|---|
| Administration codes depend on documented start and stop times, and the nursing note often has one of the two | Tie infusion administration codes to documented start and stop times, not to estimates |
| Drug units and wastage are billed from a vial, and a rounding habit becomes a repeated underpayment or an audit finding | Track drug units and wastage against the vial actually used |
| Prior authorizations expire quietly, and the first sign is a denial 45 days after the patient sat in the chair | Watch authorization windows and unit limits before the patient is scheduled |
Who is this for?
Same visit, three different settings.
You buy and bill your own drugs
Units and wastage are your margin. You need every vial reconciled against what was billed, every visit.
Infusion sits inside a clinic
Infusion charges compete for attention with everything else the practice bills. You need the time based codes checked automatically.
You bill under OPPS
Site of service changes the payment and the documentation expectations. You need charge review that knows which rule set applies.
What actually governs infusion payment
Useful if you are writing a charge capture policy or appealing a denial. Each source links out.
Payment rules for Part B medical and other health services, the federal basis for how administration and drug charges are paid.
eCFR, 42 CFR Part 414Supplementary medical insurance benefits, which set what is covered in an outpatient setting before any question of payment amount arises.
eCFR, 42 CFR Part 410Hospital based outpatient infusion is paid under the outpatient prospective payment system, updated annually, which is why the same service pays differently by site.
CMS, Hospital Outpatient Prospective Payment SystemThe physician fee schedule is republished each year with revised values, so a charge policy written 3 years ago is already out of date.
CMS, Physician Fee ScheduleCoverage determinations, manuals and transmittals are published openly by the payer of record, which is what an appeal is argued against.
Centers for Medicare and Medicaid ServicesHow does Neurobird Infusion Center work?
Read the documented time
Infusion start and stop times drive the administration codes. Where a stop time is missing, that is flagged the same day rather than surfacing as a denial in 6 weeks.
Reconcile units and wastage
Drug units billed are checked against the vial size administered and the wastage documented, so rounding habits stop being an audit finding.
Watch the authorization
Approved units and expiry dates are held against the patient and checked when the next visit is scheduled, not after it happens.
Infusion center software questions, answered
Key terms
- What is infusion center billing?
- Infusion center billing is the conversion of an infusion visit into administration and drug charges. Administration is time based, with an initial hour code and add on codes for each additional hour, and the drug itself is billed separately by units. Both depend entirely on what the clinical record documents.
Why is documented time so important?
Because the administration codes are defined by infusion duration. Reporting an additional hour generally requires documented time beyond the initial hour, and the start and stop times in the record are the only evidence. A note without a stop time cannot support the second code.
Where do the payment rules come from?
Federal payment for Part B services sits in 42 CFR Part 414, benefit coverage in 42 CFR Part 410, and hospital based outpatient infusion is paid under the outpatient prospective payment system. Commercial payers usually follow the same code definitions with their own policies on top.
How do prior authorizations get missed?
Because they are tracked per patient in a spreadsheet while the schedule is tracked per chair in a different system. An authorization with 12 approved units and an expiry date does not announce itself when visit 13 is booked.
Does this replace our EHR?
No. It reads the documented infusion times and orders, checks them against authorization and coding rules, and hands a clean charge to whatever you bill with.
Why we are building this
Infusion billing is unusually mechanical. The code is decided by documented minutes, the drug is decided by units administered and wasted, and the payment is decided by published rules. Almost none of it is a judgement call.
Which makes it strange that so much revenue leaks. It leaks because the check happens days later, by which point the note cannot be fixed and the authorization has already expired.
We would rather build this with people who work these claims than guess at it. Tell us how yours are assembled, and where we have got it wrong.
Where the requirement comes from
The federal payment and coverage rules behind an infusion claim.
- 42 CFR Part 414, payment for Part B services How administration and drug charges are paid under Part B, including the basis for drug payment.
- 42 CFR Part 410, supplementary medical insurance benefits What is covered in the outpatient setting, the question that precedes any payment amount.
- CMS, hospital outpatient prospective payment system The annually updated payment system for hospital based outpatient infusion.
- CMS, physician fee schedule Annual values for services billed in the office and freestanding setting.
How much does Neurobird Infusion Center cost?
Priced per infusion suite because the volume follows the chairs. Unlimited users and claims checked on every tier.
- Administration time checks
- Unit and wastage reconciliation
- Charge review queue
- Denial reason tracking
- Email support
- Everything in Single suite
- Prior authorization tracking
- Chair time versus billed time
- Payer policy rules
- Named contact
- Everything in Multi site
- Cross site reporting
- EHR and clearinghouse sync
- Appeal pack generation
- Onboarding included
Get free early access
If you bill infusion, tell us where the charge actually comes from today and what your top denial reason is.
Straight answer on where this is: In development. Early access gets the working preview, a say in what ships first, and early access pricing. It does not get you a login today.
Prefer email? Write to office@neurobird.com and a person will reply. No autoresponder.