Coverage and Reimbursement Support

Coverage and Reimbursement Support2018-12-10T11:28:03+00:00

Coverage and Reimbursement Support

Minimize barriers that can delay or prevent access to medication.

Coverage

  • Business Intelligence (BI) to Determine Benefit Options and Guidelines
  • Secure Pre-certifications and PAs
  • Seek Formulary Exceptions and Appeals of Restrictive Coverage or Exclusions

Reimbursement

  • Tracking of Physician Reimbursement Rates
  • Patient Cost-Sharing Determinations
  • Patient Affordability Options

Coding and Billing

  • HCPCS, CPT, and ICD-10 Coding Counseling
  • Claims Submission Guidance and Strategies
  • Billing Miscellaneous J-Codes/C-Codes

Claims Management

  • Evaluation of Rejected, Denied, Under-reimbursed Claims
  • Direct Payer Engagement
  • Strategies and Intervention for Resolutions

Pharmacy Coordination

  • Specialty Pharmacy Triage
  • Facilitate Communication Between SPP and Patient
  • Expedite Fulfillment and Promote Adherence

Alternate Resources

  • Identify Options and Serve as Patient Advocate
  • Coordinate Application, Enrollment, and Access to Funds
  • Monitor Fund Availability Across Multiple Resources

Related Resources

Discover how TC Market Access supports patients through their treatment journey.

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Contact us for answers.

Joe Abdalla
Chief Commercial Officer
joseph.abdalla@trialcard.com
919-­415­-3103

Scott Dulitz
Chief Strategy Officer
scott.dulitz@trialcard.com
919­-415­-3232