As most of us go about our everyday lives, we often don’t think about those that are living with a devastating illness. Those people and their families need support, encouragement, and guidance throughout their journey to and through treatment. Speed to therapy is the goal for all patients, but they can face obstacles from the moment they are prescribed with insurance coverage, cost of therapy, and successful, long-term adherence
For therapies that utilize patient support services, case managers strive to alleviate as many burdens from the families as possible. By forming partnerships with the prescribing physician, insurance provider, pharmacy, and patient, case managers oversee the collective hurdles a patient and their family are facing.
At prescription, case managers complete extensive benefits investigations, prior authorization/appeal support, and payer follow-up. Adding any additional documentation that is needed and ensuring the patient can receive their therapy with full coverage clears the first hurdle after diagnosis. Patients can also be offered co-pay assistance or foundation support. Case managers guide the families to websites that help with items like durable medical equipment, disease state educational materials, nutrition considerations, treatment center location, and connecting with other patients.
Once coverage and financial support have been determined, case managers also walk families through the process of obtaining the medication and support the triage process. As patients begin their therapy, case managers may arrange for training on injectable therapies, as well as conduct routine follow-up calls with the patient as a continued support system throughout their treatment.
For patients dealing with unique or complex therapies, these steps could represent drop-off points before any meaningful impact is achieved. By setting up a case management system to support them and their families, their potential to start therapy and complete their full course of therapy is greatly enhanced.
At UBC, our experienced case managers are equipped to handle each barrier your patients face. Coupled with leading eServices to optimize the process, our high-touch, high-tech system fosters optimal outcomes for patients. To learn more about how we can support your patients through their therapy journey, visit https://ubc.com/patient-support/.
About the Author
Ashley Bennett is a Program Manager for UBC’s Patient Access Services who brings 22 years of experience in the healthcare industry including 15 within the UBC Organization. In her role, she supports patients’ access to therapy through open collaboration with pharma and biotech.
