Hub Services, The Patient’s Advocate
Tuesday, August 30, 2022
You haven’t been feeling well for quite some time. You have always been a healthy individual, so you push through the first warning signs that something might be wrong and continue to move on. You allow more time to pass, but those warning signs get louder and harder to ignore. Now, you find yourself in front of your doctor with the news that those signs mean a debilitating illness is part of your life. You can’t even pronounce the name of your disease, let alone articulate the drug course your prescriber is recommending. Everything around you now has become white noise.
In comes your Hub team. As an ever-evolving partner within the pharmaceutical space, Hubs have become an important patient-centric single point of contact for all stakeholders within the scope of patient care. As confusing as any disease state could be, not knowing who your advocates are could make the situation even more frustrating. As patients begin to navigate their new illness and fit it into their already busy daily churn, the Hub assists in connecting all the dots for them. Once the prescriber and patient decide on the best course of treatment, the Hub takes over ensuring the patient quickly begins their treatment regimen.
The initial step is ensuring the patient understands the financial breakdown of starting and staying on this new therapy. As more breakthrough therapies and orphan drugs emerge into the market, the processes for payor coverage become more challenging. A Hub will partner with the patient’s insurance payor to ensure that all coverage determinations and potential payer policy requirements are met prior to the medication being dispensed. As the central representative for the patient’s specialty process, a Hub will provide the patient’s prescriber with updates on coverage status, prior authorizations, and even walk the prescriber through the steps of appeals, if needed. While assisting patients in their reimbursement process, a Hub finds payor outliers that are shared with pharma manufacturers, allowing these manufacturers to work hand in hand with many payors in creating the most transparent and smooth process for drug coverage. Because of the extensive knowledge gained focusing on a medication’s billing codes and overall adjudication process, a Hub reduces overall claim processing time. This can drastically reduce the time it takes a patient to start critical therapies.
As the road for initial patient fill continues, the Hub monitors the filling progress at the specialty pharmacy. Through their specialty liaisons, the Hub can assist the specialty pharmacy in providing feedback on a number of questions involved in shipping the drug to the patient’s home or treatment facility. Many of these drugs need high-touch care to ensure appropriate drug administration. Based on each drug’s specific need, the Hub partners with patients to provide support from our extensive network of nurses. This allows patients to receive the highest level of care, even from the comfort of their home. In addition, the Hub provides patients the opportunity to connect with our clinicians to answer any questions or concerns as they continue their therapy. Even after the first dispense, the Hub continues to support and assist patients as they journey on the path to better health.
UBC’s subject matter experts and deep experience help us guide patient journeys and drives exceptional care and outcomes by customizing solutions for leading brands and their patients. Our three main pillars include access and affordability, clinical education, and care coordination. UBC understands that manufacturers need to partner with a provider that can customize services to meet the unique needs of the patient and prescribed therapy.
About the Author
Andy Garcia is an Associate Director of Patient Services at UBC. He is an industry leader with more than 15 years of experience focused on patient support, front-end pharmacy operations and program design, implementation, and strategy.