Structured factoring for workers' compensation pharmacy receivables

CompRx purchases eligible receivables from Pharmacy Benefit Managers (PBMs) and offers them for purchase to investment entities at market rates.

How It Works

The program has two phases: a 6-month pilot, then an ongoing factoring arrangement based on the validated Net Realized Value (NRV).

Phase 1

6-Month Pilot

CompRx assumes full financial responsibility for the cost of medications dispensed through the program.
The investment entity incurs no upfront financial exposure and receives no reimbursement for claims submitted during the pilot.
Prescriptions are submitted to the partnered mail-order pharmacy or the patient's preferred pharmacy. CompRx bears the risk of delayed, partial, or denied workers' compensation reimbursements.

Phase 2

CompRx Program

Eligible workers' compensation pharmacy receivables are made available for purchase to qualified investment entities at a defined discounted rate based on the validated NRV.
Purchase Price = NRV × 70%. That is the price the investment entity pays for submitted claims.
The investment entity receives payment on purchased receivables once they are collected, and assumes the collection risk.

Examples

The $100 claim shows how factoring is calculated. The portfolios below are from a completed historical program.

How a $100 claim is factored

This illustration uses an 80% collection rate (NRV) from the 6-month CompRx Pilot. All figures are illustrative only. Actual results will vary.

$0$50$100

$0$20$40$60$80$100

Billed Claim Amount

The full amount billed.

$100

Net Realized Value [NRV] (80%)

Verified average reimbursement in this illustration.

$80

Purchase Price (70% x NRV)

What the investment entity pays: $80 × 70%.

$56

Factoring ROI

$80 collected minus the $56 purchase price.

$24

Completed portfolios

Past performance is not indicative of future results. All investment figures shown reflect actual historical data from a completed portfolio. Projected figures are estimates based on Net Realized Value (NRV) calculations and are not guaranteed.

Single Prescriber Receivables

Total Claim Amount Billed

$200,548.03

Net Realized Value (34.14%)

$68,467.10

Purchase Price (NRV x 70%)

$47,926.97

Realized ROI After 30 Days

$51,344.63

↑ $3,417.66 (7.13%)

Expected Return on Investment

$82,918.45

↑ $34,991.48 (73.01%)

Multi Prescriber Receivables

Total Claim Amount Billed

$261,231.20

Net Realized Value (47.31%)

$123,588.48

Purchase Price (NRV x 70%)

$86,511.94

Realized ROI After 15 Days

$89,271.67

↑ $2,759.73 (3.19%)

Expected Return on Investment

$134,249.23

↑ $47,737.29 (55.18%)

Compliance

Key regulatory considerations for the CompRx program.

Anti-Kickback Statute & Stark Law

Physicians are not permitted to purchase the prescription account receivables. No compensation is paid to physicians for patient referrals. Prescription routing to the mail-order partner is always patient-directed and voluntary.

HIPAA

All protected health information (PHI) is handled in accordance with HIPAA. Appropriate Business Associate Agreements (BAAs) are executed with all applicable parties.

State Workers' Comp Regulations

CompRx operates in compliance with applicable state workers' compensation statutes and pharmacy billing requirements in each jurisdiction where the program is offered.

Factoring Disclosure

The sale of accounts receivable through factoring is a recognized and lawful financial arrangement in healthcare. Factoring does not constitute a loan or a debtor-creditor relationship between the entity and CompRx.

Contact

Call or send a message to ask about the 6-month pilot or the ongoing CompRx factoring program.

Send a message

Include your name, contact information, and a brief description of your inquiry. Please do not include protected health information (PHI).