Commitment to Initiation and Continuity of Care

Patient Access Team at Accredo helps patients access therapy quickly

Commitment to Initiation and Continuity of Care

Specialty products need specialty expertise and solutions, and often that extends beyond product and patient care to focused financial assistance counseling and support.

The costs for specialty drugs can be thousands of dollars per month per patient. Even with health insurance, costs can put treatment out of reach — unless patients get help. That’s the job of the Patient Access team at Accredo, a team of 186 specialists located around the country.

The team’s primary responsibility is to ensure that patients in need have some avenue for payment. They review coverage of every patient that comes to Accredo for therapy, which can be several hundred on any given day.

After determining whether the patient has health insurance or Medicare or Medicaid, the team looks into the patient’s out-of-pocket costs, including copays and deductibles. Where there’s a shortfall, they get to work making up the difference.

The Patient Access team works closely with manufacturer-funded Patient Assistance Programs and with charitable foundations to help patients without insurance or help to fill the gap between insurance coverage and their costs including copays and deductibles. Where there’s a shortfall, they get to work making up the difference.

The team refers and assists more than 6,000 patients yearly in receiving financial assistance from manufacturers, foundations, or both. However, the need for alternative funding continues to grow, and Patient Access now has a dedicated team for research and knowledge of new sources.

The Patient Access specialist typically speaks to the patient numerous times when he or she is first diagnosed. They have a challenging job of explaining the healthcare benefits and out-of-pocket costs. This requires a specialist in reimbursement who also understands the disease state and the life-sustaining nature of the medications.

The team must be prepared to speak to a wide range of patients and caregivers, who could use a strong dose of good news after receiving a diagnosis of a life-threatening condition associated with mind-boggling expenses.

The team has found that patients’ outlook improves noticeably when they receive a list of alternative funding sources with a side of sincere empathy.