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Pharmaceutical companies can utilize RM Healthcare's Pharma Market Access Services to ensure their patients have access to timely, affordable medical care. To reduce the risk of patients not taking their medication, we get rid of any potential barriers. Our highly trained international team has the potential to serve as an extension of your in-house team of US-based case managers, assisting with tasks such as benefit verifications, patient enrollments, payer follow-up, and prior authorization support.
It is essential that patients are enrolled as quickly as possible so that they can begin receiving medication as soon as possible. We have made everything as easy as possible. Our Member Enrollment team creates a customized eFax queue for each client in order to ensure that the intake and patient enrollment documents are sent to the correct location. Following the inspection of each fax, a new patient case will be initiated on our website. As soon as everything is in its proper location, the cases are stacked up and put in a line to be evaluated for qualification. If it turns out to be necessary, a member of our staff will get in touch with the customer personally to obtain any information that may be lacking.
The administration of authorization requests is often a process that requires a significant amount of both time and effort. Nevertheless, success in this step is necessary for winning the case. The team of qualified professionals at RM Healthcare is able to take care of the prior-authorization process on your behalf.
Before beginning any new therapies, our staff ensures that patients have obtained the necessary authorization by collaborating with clinics, insurance providers, and manufacturers. But that's not the only thing we do here. In the event that your request is turned down, we will also handle the procedure of appealing the decision. We check in with the payer to make sure that they have received the appeal documents, and we maintain communication with them until the appeal has been decided.
At RM Healthcare, the insurance specialists' main responsibility is to verify that patients meet the requirements for coverage and eligibility. In order to collect accurate data, we make use of a wide range of means, including but not limited to the telephone, payer portals, electronic communication (email, fax, and so on), and more. Determine the secondary and tertiary providers that you have access to. After making sure that the treatment is covered by the insurance provider and the pharmacy benefit manager, we enter the relevant information into the client site. If permission isn't necessary, the data will be sent straight to the manufacturer. If it is required, we will also handle the procedure of obtaining permissions.
