Here's a look behind the scenes to
show how our specialty pharmacy helps
address specific requirements for
specialty patients and creates
a treatment plan based on their needs.
When we receive
the referral for the prescription,
we load images of
the information you send into our system,
create a patient profile
and verify the prescription.
Next, we verify patient benefits.
This involves identifying
the appropriate medical or pharmacy benefit,
adjudicating the claim,
determining out-of-pocket cost and
if rejected, determining next steps.
For example, if
a prior authorization is required,
the PA form is completed,
sent to the prescriber
for review and submitted.
Additionally, in the event of denials,
we exclusively offer a team of nurses,
along with clinicians
and administrative experts
to coordinate the appeals process
from start to finish.
So you don't have to.
Then if the patient
can't afford the medication,
we identify if they're eligible for
co-pay assistance and help
with third-party foundation grants.
We then create the care plan,
calling your patient to setup shipment
we'll leave a message if the patient
needs to call us back.
These steps help ensure patients get
the specialty medications they
need when they need them.