Pharma

Aug 31, 2017

Pharmaceutical manufacturers strive to get patients on therapy faster and minimize patient drop-off. Engaging the reimbursement hub services of a white-glove partner—such as WRB, an EnvoyHealth company—is a powerful way to improve efficiencies and ensure value.

WRB’s white glove approach to its reimbursement service includes experienced reimbursement specialists supporting a patient’s needs throughout their journey.  Reimbursement specialists help guide patients through the full complexities of the reimbursement landscape. WRB offers a wide range of reimbursement services that vary in complexity, such as:General program inquiries receive an immediate verbal response from a trained reimbursement specialist. This begins to build the relationship needed to ensure adherence and compliance.

  • General program inquiries receive an immediate verbal response from a trained reimbursement specialist. This begins to build the relationship needed to ensure adherence and compliance.

Simple inquiries are typically addressed using internal resources and minimal research. These might involve intake of patient-specific information or general reimbursement and coverage questions.

Reimbursement professionals always consider the needs of specific patients and can provide more complex service or follow-up when needed.

  • When a request requires specific patient or payor information, the reimbursement specialist uses external sources, such as calls to payors, to gain a complete response. This response is used when verifying benefits.
  • When a request requires specific patient, provider, or payor information, the reimbursement specialist begins with the steps outlined above and continues to develop the case as its complexity increases.

For example, after a claim denial, the reimbursement specialist must initiate the proper activities to resolve it, whether that means, facilitating a prior authorization, helping with an appeal, or providing payor education on Current Procedural Terminology (CPT) codes.

Reducing Obstacles to Reimbursement

It is no longer enough to educate providers and expect maximum payor reimbursement. Process improvements require a trained staff of reimbursement hub experts.

It’s to your advantage to engage WRB as your white-glove services partner.