Handling insurance claims and processing insurance are important functions within the pharmacy. There are roles dedicated to dealing with insurance claims, payer policy, and prior authorization. Dr. Amanda DeMarzo, PharmD, MBA, PACS is the Associate Director, Patient Access with the National Board of Prior Authorization Specialists. She encourages enhancing patient access through education and certification. […]
Category Archives: blog
4 Lessons Learned in Access & Reimbursement
Patient access and reimbursement is a unique role as it functions between patients, providers, and payers. Being able to navigate the payer policies and get patients access to much needed therapy comes with valuable knowledge. As reimbursement and patient access does right by patients, there are lessons to be learned and shared with the rest […]
Field Reimbursement Manager: A Day in the Life with Deena
A field reimbursement team is an extension of a provider team, advocates, and navigators. With skills and experience in coverage and access support, field reimbursement professionals can provide additional knowledge and support with healthcare offices daily.
What are Biosimilars?
Biologic products are drugs that have regulation by the United States Food and Drug Administration. They have utility to diagnose, prevent, treat and cure medical diseases and conditions. They are usually large and complex molecules and are harder to characterize than small molecule drugs. Common and familiar biologics include etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), […]
Telehealth and You: The Future of Healthcare
Since the inception of the COVID-19 pandemic, telehealth has been a huge topic of discussion. We see surveys and data on telehealth regularly as the industry forges ahead with technology. Some say that the implementation of virtual engagement at this scale was expected in the next ten years. But the change happened in a few […]
5 Challenges for Patient Access in 2021
Patient access is at the forefront of healthcare policy and mainstream media as the pandemic and vaccination distribution continues. In 2020, we saw vast attention on prior authorization, patient access, and related-issues making appearances in healthcare policy. We saw time spent on Step Therapy, Copay Accumulators, Prior Authorizations, and Out-of-Pocket Costs at the local and […]
What is a Managed Care Pharmacist?
Managed care is a method for optimizing patient health using evidence-based medication strategies. The purpose is to enhance the quality of healthcare for all patient populations while reducing the cost. Managed care is beneficial for patients and the health care system when used appropriately. Although certain aspects may be tedious and limiting, managed care plays […]
Summary: Patients, Need a Helping Hand with Prior Authorization?
Prior Authorization is often viewed as a complex and confusing subject. It complicates the patient care process via a series of troublesome obstacles that are regularly associated with insurance policies. Dr. Amanda DeMarzo, an advocate of improving patient care outcomes via improved methods of training and education, as well as a leading figure of the […]
4 ways a Biden Presidency will impact prior authorization and reimbursement
The 2020 Election results were considered by many to be one of the most important to the U.S. Not only were there the highest number of votes, but several looming healthcare issues such as COVID19, the opioid crisis and drug pricing were top of mind for many Americans. President elect Biden will be inaugurated later this […]
What is Managed Care?
Managed care is a method of optimizing patient health using evidence-based healthcare strategies and resources. The purpose of managed care is to enhance the quality of healthcare for all patient populations. Managed care revolves around the collaboration of health insurance plans and healthcare providers. Managed Care includes healthcare plans that are used to manage cost, […]
