AccessMED designs and administers centralized-point-of-contact reimbursement support programs customized to your products and customers. Through the following programs, we work with you to design and develop a unique program carefully crafted to your specifications:

• Reimbursement Case Management
• Patient Assistance Programs
• Patient Education
• Practice and Facility Resources
• Technology Solutions

Reimbursement Case Management

AccessMED assembles a dedicated reimbursement case management team and creates a contact management database for each client. We consider your specific reimbursement challenges, prescription indications, product administration sites, and patient needs in developing a unique program that meets your goals.

Our case management services include

• establishing a hotline for frequently asked questions about billing, coding, payer coverage policies, and general program operations;
• conducting benefits investigations to assess insurance coverage status and provide financial counseling to patients;
• searching for alternative coverage if a patient’s insurance doesn’t provide adequate prescription drug benefits;
• helping gain prior authorization for prescriptions and prepare appeals for denied requests; and
• providing appeals assistance through Medicare Part B redeterminations, QIC reconsiderations, administrative law judge cases, and other appeals processes.

Patient Assistance Programs

AccessMED works closely with manufacturers to develop assistance programs that make products available to low-income patients and patients with high out-of-pocket costs, including patients who need help with Medicare Part D “donut hole” expenses. Our programs first seek alternative funding or coverage before using solid screening tools to qualify patients for manufacturers’ philanthropic programs.

Our patient assistance programs include

• screening and qualifying low-income patients for manufacturer-sponsored patient assistance programs that provide free goods,
• connecting patients who have high out-of-pocket costs with charitable foundations that provide copay assistance, and
• helping patients continue treatment protocols when expanded access programs or clinical trials end.

Patient Education

Patients encounter a staggering amount of information when making major decisions about paying for health care. AccessMED’s reimbursement counselors educate patients about their options and resources by

• facilitating Medicare Part D Low-Income Subsidy (LIS) applications for qualifying patients;
• advising Medicare Part D enrollees about various plan options and benefits;
• helping patients apply for State Pharmacy Assistance Programs (SPAPs), which can help meet the high copay requirements of Medicare Part D;
• providing information, referrals, and assistance in applying for charitable foundation programs that help cover high copay costs; and
• helping patients access grant programs to cover expenses such as transportation and utility bills.

Practice and Facility Resources

AccessMED administers manufacturer-sponsored reimbursement support programs that help health care providers offer financial counseling to patients or seek payer coverage for prescribed treatments. Through our telephone hotlines, we

• help providers with billing, coding, and coverage issues;
• provide claims review assistance, including peer-reviewed supporting materials; and
• offer access to a comprehensive database of payer policies.

Technology Solutions

AccessMED provides a variety of electronic data-sharing tools customized to meet each client’s needs. We also offer secure Web solutions that allow practices, manufacturers, and pharmacies access to real-time data.

Our technology solutions include

• a proprietary case management system, ACM™, that we customize to meet the specific needs of each manufacturer and product;
• individualized reporting, measurement, and analysis;
• electronic data exchange interfaces with manufacturers, pharmacies, and the Centers for Medicare and Medicaid Services that facilitate secure product ordering, shipping, and tracking;
• state-of-the-art call center technology that supports integrated fax functionality and streamlines the case management process; and
• a wide selection of Web-based tools such as on-line applications, real-time reports, Web hosting, and status checks for case management and patient assistance program applications.