Field reimbursement and patient access continues to be at the forefront of everyone’s mind as we approach 2021. The politicians are noticing how healthcare can make a lasting impact on Americans and they will continue to push for healthcare legislation. Patient advocacy and ensuring patient access will be bigger than ever in 2021.
Therefore, field reimbursement teams will be pivotal in making sure the healthcare landscape is well-navigated. In some cases, making sure the right patients get the right treatments is what it takes to make it to market.
As field reimbursement continues to flourish, teams will need to stand out amongst the rest. Becoming best in class is attainable if you focus on the 5 ways your field reimbursement team can stand out in 2021.
Training and education of a field reimbursement or patient access team can be difficult. With team members of many different backgrounds, it can be challenging to level-set and ensure a minimum competency.
Efforts have been made in the past to train teams as coders, billers, or even practice managers. But the curriculums don’t get to the heart of the field reimbursement role. Understanding the insurance landscape, how to navigate it, and assist providers in that process is a footnote, if it’s covered at all.
Fortunately, the Prior Authorization Certified Specialist (PACS) program covers all these areas and more. Comprehensive, interactive training focused on prior authorization, payer requirements, and how to navigate the healthcare landscape in the United States can set your team apart in 2021.
2. Issue Resolution
There is no doubt that issues will arise regarding your product and payers. But timely issue resolution will make a significant difference in prescribing habits. If your reimbursement team is quick to help and find solutions to the problems at hand, the practice will know your team is a resource for them. You can be proactive and inform the practices of the pain points that they are likely to encounter to make the process easier.
Each provider will encounter challenges and roadblocks in their practice but getting approvals for your products doesn’t have to be one of them.
The healthcare landscape follows trends and coordination between team members and regions will make a difference with minimizing surprises in payer requirements. Coordination of the team can bring to light some common roadblocks you and the providers will encounter. Accordingly keep an open line of communication between members of your team to ensure success.
4. Providing Useful Data
Gaining access to treatment isn’t always black and white. These decisions on the payer side are made by medical professionals with different backgrounds or specialties. There is a lot of grey and a lot of clinical judgement based on the presented information. So what’s stopping you from providing the most relevant data for consideration?
As a field reimbursement team, you have access to some of the most knowledgeable people about your products – medical affairs. Ask them what clinical trials or HEOR studies can support claims that are not getting approved on the first try.
5. Go Above & Beyond
The field reimbursement role is one that supports the providers’ medical decisions and ensures the preferred treatment is paid for by the payers. The role itself is inherently one that acts for the best interests of the patients.
But what does it mean to do the job and be a patient advocate? Going above and beyond the expectation!
We all want to see patients have the best outcomes with the treatments the physician feels would see the best results. So, let’s do everything we can to get that for them!
The National Board of Prior Authorization Specialists (NBPAS) is an ACMA company focused on setting benchmarks of excellence for the life sciences and healthcare industries. We specialize in improving prior authorizations by reducing denials and increasing revenue retention associated with reimbursement claims. So, set your field reimbursement team apart with prior authorization and reimbursement knowledge that can raise your bottom line through the Prior Authorization Certified Specialist program (PACS).