How You Can Turn Personal Injury Prescriptions Into Predictable Revenue IT PAYS TO DO PI RIGHT
If you’re still letting PBMs dictate your margins, stress level, and future, it’s time to make a change. Personal Injury prescriptions (commonly called PI) can be the change you’re looking for when done correctly. Let’s talk about how to do this the smart way. WHAT PI REALLY IS PI is the business of caring for patients who were injured in incidents like auto collisions, slip-and-falls, or other negligence-related events where an attorney is involved. Instead of insurance paying immediately, the medical costs (including prescriptions) may be reimbursed later from a legal settlement. The patient needs medication now, the case resolves later, and the pharmacy has to decide how and when it gets paid. WHY PHARMACIES ARE ATTRACTED TO PI When structured properly, PI can be one of the cleanest non-PBM revenue streams available. 1. You’re not playing the reimbursement roulette that comes with PBMs. Pricing is transparent and intentional. 2. These are patients with immediate, legitimate need, often involving repeat fills during recovery. 3. PI creates sticky referral relationships with attorneys and clinics. The catch? Cash timing . If you don’t set rules up front, PI can swiftly become your most frustrating AR bucket. THE LETTER OF PROTECTION (LOP): WHAT IT MEANS The most common PI payment mechanism is the Letter of Protection (LOP) . This is a document from the patient’s attorney asking you to dispense now and wait to be paid later from the settlement. LOPs are typically used when patients can’t afford out-of-pocket costs or when insurance isn’t being used strategically during litigation. They can be useful, but only if you understand the risk and manage it deliberately. STATE RULES MATTER MORE THAN YOU THINK LOP practices vary widely by state. Some markets use them daily; others treat them cautiously or require additional steps. This
is not a place to wing it. A simple way to get oriented is to search: “[Your State] letter of protection medical provider” “[Your State] medical lien statute personal injury provider” “[Your State] attorney lien health care provider settlement” Then, validate what you find by calling your state pharmacy association, a local health care attorney, or even your liability carrier. Your goal is to learn what documentation is required, what notices matter, and what happens if a case doesn’t settle. HOW PHARMACIES LOSE MONEY IN PI Most PI losses slip right by you. Common mistakes include: • Dispensing without written payment terms • Failing to verify attorney representation • Losing documentation • Letting AR sit untouched for months The biggest misconception? Assuming an LOP equals guaranteed payment. It doesn’t. It’s an agreement to seek payment from settlement proceeds. WHOM YOU ACTUALLY WANT TO WORK WITH You’re not marketing to just any lawyers. You’re targeting attorneys who already run a smooth PI operation. Look for plaintiff personal injury firms, especially those focused on auto, premises liability, or trucking cases, and who advertise heavily. On the clinical side, chiropractors, PT clinics, and urgent care centers that mention accident injuries on their websites are ideal partners, as these groups already see PI patients. YOUR PRACTICAL PI SETUP CHECKLIST 1. Start with a one-page intake packet: • Patient info, injury date, attorney name/ firm, and clinic name • Consent/authorization to communicate with the attorney (as permitted) • Signed acknowledgment of payment policy • Payment policy (choose your lane)
2. Pick ONE primary model and don’t improvise per patient:
• Patient pays cash (simple, fastest) • Attorney/clinic pays (invoice terms) • LOP/lien model (slower cash, higher documentation)
3. Documentation you keep tight: • Itemized invoices • Proof of dispense/pickup
• Copies of attorney letters or LOPs (if used) • Notes of communications, dates, and who promised what 4. AR follow-up rhythm (non-negotiable): • Every 14 days: confirm case status + confirm attorney contact • Every 30 days: resend statement/invoice + request updated status • One person owns this. ATTORNEY OUTREACH MESSAGE Subject: Pharmacy support for your PI clients
Hi [Name],
We’re a local pharmacy that supports PI clients with same-day fills when possible, clear itemized invoices, and consistent documentation. We can coordinate directly with your office and the treating clinic with patient authorization. If helpful, I’m happy to share our one-page PI process and billing contacts.
– [Name], [Pharmacy], [Phone]
Professional, yet short and sweet.
If you’re tired of guessing which non-PBM revenue stream will work, PI is sitting right in front of you, waiting for pharmacies willing to run it like a business, not a favor. PI ISN’T RISKY, BUT GUESSING IS Want help building it the right way? Essentials and Up members can join Coach Mike’s Daily Coaching calls Monday–Friday at 2 p.m. Central, and all members are free to check out our Community Chat at Membership. DiversifyRx.com/community/chat .
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