Simplifying Buy & Bill: How Our Spravato Billing Services Protect Your Margins

Delivering SPRAVATO® (esketamine) therapy using the Buy & Bill model can be both financially rewarding and operationally risky. Without the right billing infrastructure and distributor strategy, providers often find themselves facing cash flow gaps, denied claims, or reimbursement rates that don’t cover drug costs.

At Finnastra, we understand the stakes. As a specialized Spravato Billing Company, we’ve designed end-to-end billing solutions to help you maximize margins and minimize risk under the Buy & Bill model.

What Is Buy & Bill—and Why Is It Challenging?

In a Buy & Bill model, your clinic purchases SPRAVATO® doses from a specialty distributor upfront. You then administer the treatment in-office and bill insurance for both the drug and the administration.

While this allows for streamlined patient care and potentially higher revenue, it also introduces complexity:

• Upfront drug costs ($600–$900 per dose)
• Delayed payer reimbursement
• Risk of underpayment or denials
• Complex code bundling (e.g., G2083, S0013)
• Distributor pricing negotiations

Without expert guidance, many practices lose money instead of earning a margin on SPRAVATO®.

How Our Spravato Billing Services Support Buy & Bill Success

At Finnastra, we don’t just submit claims—we engineer every piece of your billing and revenue cycle around the realities of SPRAVATO® Buy & Bill.

1. Distributor Coordination

We assist in selecting the right distributors, negotiating favorable unit costs, and establishing payment terms aligned with your cash flow.

2. Clean Claim Submission

Our team uses proven coding workflows—like S0013 for drug cost and G2083 for 2-hour observation—to ensure each claim is clean, compliant, and optimally reimbursed.

3. Prior Authorization + Medical Necessity

We manage the front-end documentation required for prior authorizations and audits, reducing delays and denials related to Buy & Bill cases.

4. Margin Monitoring + Reimbursement Tracking

Finnastra gives you clear visibility into each claim’s cost vs. reimbursement, so you know exactly where your margins stand and which payers need renegotiation.

5. Audit Readiness

Buy & Bill increases the risk of payer audits. We make sure your documentation is REMS-compliant, time-stamped, and audit-ready from day one.

Case in Point: Buy & Bill Optimization in Action

Clinic Type: SPRAVATO® Provider, Delaware
Initial Problem: Reimbursed $1,100 per session, while incurring $875 in drug and staffing costs
Finnastra Intervention:

• Renegotiated distributor terms with 30-day payment grace
• Adjusted claim strategy to capture additional CPT add-on codes
• Achieved new reimbursement of $1,500/session

Net Outcome:
Profit per session increased from $225 → $625+
Denial rate dropped from 12% → 2.1%

Why Choose a Specialized Spravato Billing Company?

SPRAVATO® is not your typical medication—and the Buy & Bill model demands specialized attention. Unlike general medical billing services, Finnastra’s Spravato Billing Services are built from the ground up to address:

• Drug acquisition cost vs. payer fee schedule
• Bundled vs. unbundled coding strategy
• Medicaid vs. commercial payer nuances
• State-specific Buy & Bill approval timelines
• REMS and in-office monitoring documentation

We don’t just bill—we strategically manage the business side of SPRAVATO® so you can focus on patient outcomes.

Protect Your Margins. Grow with Confidence.

Finnastra ’s Buy & Bill optimization services are part of our broader mission to help mental health providers succeed with SPRAVATO® treatment—financially, operationally, and clinically.

Ready to Make Buy & Bill Work for You?

Whether you’re just getting started or looking to improve profitability, Finnastra’s specialized Spravato Billing Services are here to help.
Explore our Buy & Bill solutions
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