It is an on-going challenge in the industry to make sure to get patients their prescribed drugs on time – and to collect payments (frequently in significant amounts) in a timely manner.
Hub services providers offer a variety of services to their clients to address these challenges, including:
- Revenue Cycle Management (RCM) front-end tasks – e.g., benefits investigation and verification, prior authorizations (PAs), and Appeals
- Copay support
- Financial assistance
- Patient Assistance Programs (PAP)
- Prescription renewals
- Patient Health Management
- RCM back-end tasks (Claims management, drug dispensing, and refills).
Hubs obtain and route prescriptions to ensure quick and appropriate delivery. The client was providing hub services to 40 drug manufacturers with over 100 drugs in multiple disparate systems. For example, intake and triage was done in one system; benefit verification happened in another; and claims management, claims adjudication and Adherence/compliance occurred in a third different system.
Our client’s strategic objectives were to create a one-stop platform that accelerated the process for patients to get their prescribed drugs – and to be able to extend the platform to support future drugs and vendors with minimal changes.