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About Us
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• What we do• We are a clinical software management platform, not a compounding
pharmacy.• We are not asking you to send us prescriptions.• Our service helps doctors manage the complex process of dispensing
compounded topical medications from their own offices.• We offer a turnkey solution designed to minimally impact the providers’ daily
workflow.
• Results• Highly effective and convenient treatment for patients. More than 75% of
your patients would prefer receiving their medications during their office visit• Bring additional revenue in-house.• Increase patient compliance. Cost containment to healthcare system.
• 30% of all prescriptions are never filled• According to the Institution for Safe Medicine Practices, pharmacy "call backs" cost
your practice an average of $6 per call or $30,000/year.• 3.3 Million adverse drug events occur each year from inaccurate information relayed
to the pharmacy at a cost of $250B annually.
What is Compounding• Before the widespread distribution of manufactured products,
most prescriptions were compounded.• Today only about 5% of prescriptions are compounded.• Compounding exists today as a means to create custom
tailored medications for a patient without having to go through the FDA approval process.
• When to use a compounded medication?• Combining medications that are not commercially available.• Creating custom doses that not commercially available.• Altering the administration route of a medication (vs. oral).
• Sterile vs. Non-sterile compounding.3
Pharmacist Recommended Formulas Pain Management
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ID Formulation Anticipated Use
PM-14.0% Flurbiprofen4.0% Cyclobenzaprine4.0% Baclofen
MSK Pain
PM-24.0% Flurbiprofen4.0% Piroxicam4.0% Lidocaine
Joint Pain
PM-34.0% Gabapentin4.0% Baclofen4.0% Lidocaine
Neuro Pain
*Custom formulations available on request
Drug Info Classification
Flurbiprofen Non-steroidal Anti-inflammatory (NSAID)
Cycloenzaprine Muscle Relaxant
Lidocaine Local Anasthetic
Baclofen Muscle Relaxant
Piroxicam Non-steroidal Anti-inflammatory (NSAID)
Gabapentin Anticonvulsive Agent
PLO Base Transdermal Cream, Absorbs Hydrophilic and Lipophilic Drugs
Pharmacist Recommended Formulas Wound Care & Scar Prevention
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ID Formulation Anticipated Use
WS-1
4.0% Phenytoin 4.0% Itraconazole4.0% Muprirocin4.0% Lidocaine2.5% Pentofixylline
Post-operative formulation for accelerated wound healing and pain relief.
WS-2 4.5% Phenytoin4.5% Metronidazole
For wounds with no pain but have odor
WS-34.1% Phenytoin4.1% Metronidazole8.2% Lidocaine
For painful wounds with odor
WS-44.3% Metronidazole4.3% Pentofixylline4.3% Lidocaine
For diabetic ulcers and pressure sores
Drug Info Classification
PhenytoinPromotes granulation, decreases exudates, alleviates pain, has antimicrobial properties, and counteracts inflammation
Itraconazole Anti-fungal Agent
Lidocaine Local Anasthetic
Mupirocin Antibiotic Agent
MetronidazoleAntibacterial and antiprotozoal agent with effective coverage against many anaerobic organisms and used topically it provides control of wound odor
Pentoxifylline
Increases blood flow and oxygen delivery to the wound site improving circulation and when used topically, it can improve the rate of wound healing by improving the ability of calcium blockers to reach the wound tissue.
SteraBase Water Washable Wound Care Base
Compounding vs. Manufacturing
• A compound is by definition a Patient Specific Medication.• Not regulated by the FDA, our system does not go through
FDA approval process. Ingredients are FDA approved for safety and stability.
• Compounding is instead governed by USP 795 Guidelines.• Repackaging and re-labeling not state or federal compliant.• A compound is called by its generic name. (ex: 20% Baclofen)• Free samples / promotion of compounds are not common
practice.• Compounds cannot be transferred or sold between
pharmacies.6
Physician Dispensing Regulations State by State
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OCS Requirements• Provider Licensing (differs state by state)• Compounding can be performed by any clinical employee but
must be signed off by MD, like any prescription normally would.• Governed by same state pharmacy laws as dispensing.• Governed federally by USP 795 Guidelines for low risk non-sterile
compounding.• Most states do not mandate / enforce that these guidelines are
upheld, however OCS will require you to.• Facility Requirements• The designated workspace should be in a clean well lit area. • A minimum of 3’ x 3’ of counter top is recommended.• Cabinet to store medications.• Computer with internet access nearby.• OCS will provide all other necessary equipment (Mixing machine,
label printer, labels, scale, small refrigerator, etc.)
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Compounding Area Setup
Most facilities can be setup in less than an hour!9
Workflow Integration
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• Designed with minimal impact to workflow.• Each compound takes less than 3 minutes to make and dispense.
• Medications will come pre-measured for weight and volume.• Utilize innovative mixing & dispensing jar.
• Value of Software• Automated inventory & expiration management and private insurance
adjudication.• Generates labels, formula worksheets, and records compliant with USP 795
Guidelines.• Accounting, Reporting and Tracking Features• Once dispensed, the prescription is transferred over to our highly specialized
billing team.• OCS will bill and work the claim on the providers behalf, returning 50% of net
collections on a monthly basis.• Starting 45 days after dispensing the provider will begin to receive
reimbursement from the insurance companies.
Medication Packaging• 100g PLO Kit (2 part)• Highly effective transdermal gel used in pharmacy compounding.• Two part kit, when combined transforms into smooth cream.• Hydrophilic – Absorbs hydrophilic drugs. Liquefies below room temp.• Lipophilic – Absorbs lipophilic drugs. Liquefies at room temp.
• Prepackaged Medications• Highly Accurate (Tested to within 1% of expected weight).
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Innovative Mixing / Dispensing Jar• Integrated Mixing / Dispensing Jar• Easily attaches to OCS mixing machine.• Integrated design, no need to transfer after mixing.• Disposable blade will stay in jar after mixing.• Designed to hold up 100g-140g of topical cream (30 day supply).• Patient friendly design, push bottom to dispense.
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Covered Insurances• Commercial Insurance• Electronic Billing• About 50% of plans will cover compounding, and co-pay may be involved• Adjudication is real-time, payment cycle is 30 days.• MD never has to “roll the dice” or guess for coverage and patient responsibility
• Workers Compensation & PIP• Paper Billing on HCFA 1500• Bills under codes 99070, DSPNS, COMPD (Depending on Carrier)• Billing cycle takes anywhere from 45-120+ days
• Medicare• OCS will not work any federal funds for our program. Medicare will not cover
compounded medications.• Cash Pay• Providers may bill patients directly if the service is not covered.• OCS will charge a $30 software/service fee for these claims.
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• Coverage and Patient Responsibility may vary across plans and carriers
• There is no way of knowing this prior to adjudication, however provider may discover patterns with certain carriers.
• Reimbursement is determined off contracts negotiated with Payors and PBMs prior to starting.
• OCS works as a PSAO (Pharmacy Service Administration Organization) to actively negotiate and maintain these contracts on behalf of the provider.
• We work in a standard fashion as a 3rd party billing service.• Typical contracts are for 70%-80% of AWP (Average Wholesale
Price or maximum allowable by state).
Commercial Contracting – Overview
Commercial Insurance - Process
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• Using OCS Rx the provider submits a request for adjudication.• Our specialized team submits the claim electronically and
within 15 minutes returns adjudication information.• Reimbursed Amount• Patient Responsibility
• The provider will then have the option to dispense to the patient or to return the compound to inventory.• If returned claim will be reversed within 24 hours.• In the event a compound is not reimbursed, the cost of meds will
be refunded back to the MD• On a monthly basis OCS will return 50% of net collections to
the provider and provide detailed reports for accounting.• Net Collections = Gross Collections – Cost of Medications
Billing InformationWorkers Comp / Personal Injury - Overview
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• At the time of dispensing the provider will submit their Usual & Customary Charges.
• OCS will verify patient / insurance information, then generate and send the claim out on a certified claim form (HCFA-1500).• Codes Used: 99070, DSPNS, or COMPD.• Each component submitted as a line item detail.
• OCS’s highly specialized billing team will work the claim and post payments w/ EOB’s attached.
• On a monthly basis OCS will return 50% of net collections to the provider and provide detailed reports for accounting.• Net Collections = Gross Collections – Cost of Medications
Representative Role Quoting and Enrollment1. Gather desired formulary and ingredients from MD2. Negotiate 50/50 or 40/60 terms3. Acquire volumes by payor (WC & Commercial)4. Create Pro-Forma and generate forms (with initial order $)5. Include proposals and legal letter of opinion in marketing folder6. Collect signatures and down payment7. Scan all necessary documents 8. Upload into software for approval9. Contact distributor to arrange training/setup schedule
***BECOME A MASTER THE SOFTWARE, IT IS OUR VALUE AND THE CORE OF OUR BUSINESS!!***
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