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TIP: When negotiating Single Case Agreements (SCA), it’s important to include payment terms. An SCA without terms can lead to lengthy delays in payment to your 340B program.
SCAs are special contracts negotiated between healthcare providers and insurance companies for providing care to patients who are out-of-network. SCAs often allow providers to negotiate better rates than typical out-of-network fees, which is particularly important in complex or high-cost cases where the provider might be assuming significant risk. These agreements are tailored to individual patient cases and outline the specific terms under which services will be provided and compensated.
In particular, the payment terms should specify the amount, method, and timing of payments. This will help reduce the likelihood of disputes and delays in payment, which can be costly and time-consuming for both parties.
Red Chip excels in securing Single Case Agreements (SCAs) for high-cost drugs across a diverse range of payers. Our trained Payer team has extensive experience and a nuanced understanding of the complexities associated with negotiating and obtaining SCAs, which is crucial for managing expensive hemophilia or transplant treatments. We are experts at navigating the challenging landscape of insurance approvals, demonstrating a consistently high success rate across various insurance providers, both public and private.
At Red Chip, we are dedicated to enhancing patient access to essential therapies, reducing out-of-pocket costs, and increasing revenue so that 340B programs can continue their role of being safety net providers.
Holly Frye is Vice President, Revenue Cycle & Reimbursement at Red Chip. She can be reached at hfrye@redchip.org
