Replies to post #124435 on Biotech Values

[DewDiligence]

I spoke to a different oncologist this morning. Her group just can't take the financial chance of not getting Provenge reimbursed. You sometimes have to wait 6 months to get paid.

You’re still mixing two issues: 1) the risk of not being paid; and 2) how long it takes to get paid.

According to DNDN, the only problem is #2; claims for Provenge reimbursement are getting paid by all third-party payers.

[AlpineBV_Miller]

There is actually a huge business opportunity here for a middleman to take on some of the risk. The middleman would evaluate patients and make a decision to guarantee payment based upon the patient profile. They guarantee to the doc they will pay if the MAC rejects the claim or delays payment.

Trick is I'm not sure some % of the $5800 provides enough money to create such a business. Not sure you could take a piece of DNDN's $93,000 for the service as your guarantee program could muck up the laws against DNDN doing this.