Collecting data to present a comprehensive view of a patient’s journey can reshape how pharmaceutical companies connect with providers and patients. This can open the door to new types of data stories that can target gaps in the patient experience and positively impact the likelihood of medication adherence.
For one pharma brand, the ConnectiveRx enterprise data platform (EDP) is doing exactly that. The manufacturer partnered with ConnectiveRx to facilitate rapid, secure access to identifiable patient information that previously was accessible only in fragments and from diverse locations.
For field reimbursement managers (FRMs), an EDP-based tool can be especially valuable. These patient advocates educate providers and their staffs about product coverage, access programs, and health policy – and are trained to resolve often complex reimbursement issues that create barriers to patient treatment. It also benefits patient access specialists, typically the first point of contact for patients when they visit their provider, who handles billing and submitting insurance claims.
A Comprehensive Picture for Field Reimbursement Managers
With critical information and supporting documents specific to a case accessible through a single, secure portal, FRMs can quickly access individual patient data and more accurately articulate a patient’s specific situation. When a provider calls about a patient but doesn’t have the case ID number, FRMs can easily locate that patient’s case details through a series of focused filters.
Because FRMs have access to the same verification of benefits that is sent to the provider detailing a patient’s coverage and benefit, FRMs are able to better support that provider. The FRM can also proactively contact the provider to determine if there are questions and review the reimbursement information and coverage details as if they were sitting side by side with the office staff. The provider in turn is able to call the patient and fully inform them about the insurance coverage (s)he will receive.
A lack of visibility into whether patients have enrolled in an affordability program and, if so, whether they are using it remains a significant challenge facing pharma brands. Connecting patient data across disparate services, an FRM portal can provide that visibility.
A portal can show that a patient started by enrolling in a hub program, for example, then was enrolled on a specific date in a copay program because it was determined (s)he was eligible, the date that the first claim was received, and that the patient is continuing to fill the prescription. This information can be customized according to the brand’s specific data needs.
Alerting Reps in Critical Situations
Custom dashboards can provide real-time email alerts to sales reps when providers have prescribed a specific medication, enabling reps to contact those providers to determine if assistance is needed with the new prescriptions. Data can be filtered in multiple ways, including by state and rep territory, helping reps stay abreast of what is happening in their regions.
Using aggregated patient information, reps can also identify trends. For example, they can set conditions to alert them if the average number of cases begins to drop below a predetermined point when a competitor has entered the market.
These tools help reps work by exception, better handling issues that arise and making sure deadlines are met so patients aren’t at risk of delaying or missing therapy. Patient benefit verification information can be validated due to integrated hub and claims, and appeal information can easily be flagged so a rep can contact the provider to help facilitate the claim.
Data can also be examined to determine the difference in prior authorization (PA) turnaround time for providers prescribing a medication who have requested hub services PA support versus those who have not.
The current prescription process isn’t nearly as simple as it should be in theory. Accessing and integrating patient data in new ways is changing how brands interact with patients and providers and helping to get and keep patients on their medication. This data integration is allowing field resources and patient access professionals to have more of an impact than ever before on a patient’s treatment journey.
To learn more about the ConnectiveRx EDP, visit here.