When referral pricing breaks cash-pay margin — add pass-through

FountainRx is built for specialty referral coordination. When insurance applies, out-of-pocket cost is determined after payor review and prior authorization — that is the correct sequence for complex, insured therapies where coordinators submit and track PA with payors before dispensing. For cash-pay clinics prescribing GLP-1s, hormones, and peptides at volume, margin lives in knowing per-vial 503A cost at the moment you quote — not after a referral clears insurance steps that may not apply to your patient mix.

A pass-through model inverts that timing for cash-pay lines. With Fizy Health, the resolved 503A landed cost appears on each catalog and cart line before you check out, and the platform's margin is a disclosed facilitation fee at payment rather than an opaque layer inside an insurance-adjusted number. The drug cost is what the pharmacy charges; the platform fee is stated separately. For a clinic quoting cash-pay semaglutide or tirzepatide daily, the price you quote and the price you pay are the same visible number.

Add pass-through pricing when referral economics actively slow cash-pay business. Common signals: you delay quoting a new cash-pay patient because landed cost is not visible until after referral and insurance steps; you run high-volume GLP-1 refill day through one-patient-at-a-time referral intake instead of a batch clinic cart; you cannot confidently set cash-pay prices because margin depends on outcomes you do not control at point of sale; or paid orders get rejected after payment for SIG or licensure issues that referral intake did not catch before you committed.

Another signal is operational split: your team keeps FountainRx for insured specialty patients but manually routes cash-pay lines elsewhere because referral paperwork is overhead for protocols that never needed prior auth. A pass-through platform like Fizy Health pairs visible per-vial cost with pre-submit cart validation and one patient-linked cart for the whole refill list. If none of these signals apply — prior auth coordination and patient refill support are central and cash-pay volume is low — FountainRx referral economics may still be the right fit. Add pass-through when the workflow model, not the vendor, is the constraint.