Four of these run on drug and infusion economics, where oncology is the hardest case and the rest fail in the same places. Two are procedural, and their money leaks somewhere else entirely. Grouping them honestly is more useful to you than a longer list would be.
A practice buys a drug that costs more than the visit, gives it to a patient whose weight decides the units, and finds out afterwards whether the plan agreed to pay for the drug, the chair and the nurse or only some of those. That is oncology. It is also rheumatology, the MS side of neurology, and the infusion suite of a GI practice. The drug names change. The machinery does not.
Orthopedics and OB/GYN are a different discipline and we would rather say so than file them under the same heading to make the list look tidy. Their money leaks inside bundled periods, in equipment and devices carried on the practice balance sheet, and in documentation that did not keep up with what actually happened in the room. Where they do touch buy-and-bill, in viscosupplementation and in contraceptive devices, they behave exactly like the drugs above.
A drug that costs more than the visit, units that depend on the patient, and a payer deciding after the fact whether it agreed to any of it. One skill, four drug lists.
High-cost drugs, unforgiving unit math, and payers that deny first and ask questions later. The hardest version of this problem, which is why we built the company around it.
The same machinery, with an extra problem on top: half the time the drug is not yours to bill at all, and which half changes by payer.
Oncology unit math stretched over a six-month clock, plus restricted distribution programs that never appear on the claim and can still invalidate one.
Two businesses in one practice. The infusion suite fails the way oncology does; the endoscopy suite fails on bundling edits and a screening that stopped being one.
No infusion suite here. The money leaks through bundled periods, documentation that did not keep up with the procedure, and queues nobody is ageing separately.
Revenue leaks inside global periods, in equipment dispensed without the enrolment to bill it, and in a work comp queue ageing on a different clock.
One bundled code covers nine months, and most of what goes wrong is a version of the same question: does the global package still apply to this patient.
