From Eligibility to Collections: What Full-Service Spravato Billing Services Look Like

Delivering SPRAVATO® treatment involves more than clinical excellence—it requires a precise, compliant, and end-to-end billing strategy. At Finnastra, we specialize in Spravato Billing Services that span the entire revenue cycle, helping mental health providers streamline operations, secure timely reimbursement, and ensure audit-readiness.

Unlike generic billing solutions, Finnastra is a Spravato Billing Company built specifically to support the REMS-regulated, buy-and-bill model. Our comprehensive billing process is designed to remove administrative burdens, maximize collections, and give you the confidence to focus on what matters most—patient care.

What Full-Service Spravato Billing Services Include

At Finnastra, we manage the entire billing lifecycle for SPRAVATO®—from patient intake through reimbursement. Below is a step-by-step breakdown of how our specialized team handles every detail of the process.

1. Eligibility Verification and Benefits Investigation

Every successful billing journey starts with a clear understanding of the patient’s coverage. Our team:

• Confirms SPRAVATO® coverage across commercial, Medicare, and Medicaid plans
• Identifies deductible, co-pay, and out-of-pocket estimates
• Verifies prior treatment history requirements for TRD diagnosis
• Documents payer-specific prior authorization policies

We provide providers with upfront clarity on reimbursement potential—reducing financial uncertainty for both the clinic and the patient.

2. Prior Authorization Management

SPRAVATO® requires thorough clinical justification. Our specialists handle all aspects of prior authorization, including:

• Completing and submitting prior auth forms with accurate ICD-10 codes (e.g., F33.2, F32.2)
• Attaching required clinical documentation (PHQ-9 scores, treatment history, etc.)
• Managing payer communication, appeals, and resubmissions
• Tracking turnaround times and ensuring timely approvals

Finnastra’s prior authorization process is designed to minimize treatment delays and increase approval rates on first submission.

3. Buy-and-Bill Optimization and Inventory Coordination

Under the buy-and-bill model, practices must purchase SPRAVATO® directly from distributors, then seek reimbursement. Our team:

• Works with distributors to confirm product pricing and delivery timelines
• Assists in negotiating purchase terms to protect your profit margins
• Tracks each patient’s dose and product usage to ensure correct billing (56mg vs. 84mg)
• Aligns charge capture with payer-specific units and HCPCS codes (e.g., S0013, G2082, G2083)

This ensures medication costs are reimbursed efficiently—and fully.

4. Compliant Claim Submission

We submit clean claims with the correct combination of CPT, HCPCS, and diagnosis codes, ensuring compliance with:

• Commercial payer guidelines
• Medicare and Medicaid billing protocols
• REMS and site-of-care requirements

Our claim scrubbing process helps prevent denials, reduces rework, and accelerates payment cycles.

5. Ongoing Denial Management and Appeals

Despite best practices, occasional denials occur. Finnastra actively monitors all claims and handles:

• Timely denial resolution
• Appeals and supporting documentation submission
• Coordination with clinical teams for clarification if needed

This helps keep your revenue predictable and your accounts receivable under control.

6. Payment Posting and Reconciliation

Once payment is received, our team:

• Posts all payments and adjustments promptly
• Reconciles payments with expected amounts
• Flags underpayments or missing reimbursements for follow-up
• Provides transparent reporting so providers can track revenue in real-time

You’ll always know what was paid, when, and why.

7. Patient Billing and Support

If patients are responsible for any portion of their treatment costs, Finnastra manages:

• Clear patient statements
• Secure payment collection options
• Responsive patient support to resolve billing questions

Our patient-first approach helps improve satisfaction while maintaining revenue integrity.

8. Audit-Ready Documentation and Compliance Oversight

SPRAVATO® treatment sites must comply with REMS, payer audits, and CMS documentation guidelines. Finnastra ensures:

• All billing and clinical documentation is organized and traceable
• Progress notes, treatment logs, and REMS submissions are cross-referenced
• Compliance risks are proactively addressed
• Support during payer audits or record requests

This gives providers peace of mind that their billing process is built for long-term success.

Why Choose Finnastra as Your Spravato Billing Company?

Providers offering SPRAVATO® cannot afford billing gaps or delays. Finnastra’s dedicated Spravato Billing Services are tailored to meet the unique financial, operational, and regulatory needs of SPRAVATO® clinics.

• 98%+ prior authorization success rate
• Deep understanding of buy-and-bill financial flows
• Seamless collaboration with distributors and payers
• Proactive denial management and audit readiness
• Transparent reporting and real-time financial insights

Whether you’re launching a new SPRAVATO® program or seeking to scale an existing one, Finnastra offers the experience and infrastructure to support your growth.

Ready to Partner with a Specialized Spravato Billing Company?

If you’re looking for a billing partner who understands the full journey—from eligibility to collections—Finnastra is ready to support you.

Explore our Spravato Billing Services
Contact us today to schedule a consultation and see how we can streamline your practice’s reimbursement process.