Study examined over 850K co-pay program claims over a year-long period
Healthcare solutions provider TrialCard announced today that results of an independent audit showed a greater than 99% success rate in allowing participation in its Patient Affordability Programs by only eligible patients. In September 2014 the Office of the Inspector General (OIG) released a study on the use of co-pay assistance programs by patients with federally-funded insurance that cited several areas where manufacturers could potentially be at risk for allowing ineligible patients to enter their programs.
“Our clients have overwhelmingly expressed that the issue of patient eligibility is of critical importance to them given the increased regulatory scrutiny in that area,” noted Michele Atchison, Chief Compliance Officer and Corporate Counsel at TrialCard. “The results from the independent review validate the quality and thoroughness of our ability to allow only eligible patients to enter a program and reinforce our position as a trusted consultant.”
Multiple methods used throughout the industry, some cited in the OIG study such as patient self-attestation upon enrollment and electronic claim edits, as well as new technologies being developed, leave gaps in patient screening and expose manufacturers to regulatory risk. TrialCard’s 99% success rate in allowing only eligible claims to be adjudicated was achieved across a sample of over 850,000 claims during a year-long period that were reviewed as part of the independent audit.
Atchison went on to note that TrialCard views regulatory compliance as an ongoing area of focus that is simply one of the realities of the pharmaceutical and broader healthcare industries. “There isn’t ever a final answer,” she stated. “We see it as our obligation to our clients to continue development of solutions that meet their needs, both today and into the future.”
About TrialCard Incorporated
TrialCard Incorporated provides product access, medication adherence, and patient support services on behalf of pharmaceutical manufacturers. Founded in 2000, TrialCard has become the largest provider of patient access programs in the industry, processing over $1 billion in reimbursement benefits per year. TrialCard holds nine US patents related to the processing and marketing of patient access programs. The company is headquartered in Cary, North Carolina. For more information about TrialCard, please visit http://www.trialcard.com.