Meeting the Prior Authorization Challenge Podcast Series – Staff Productivity

By Dan Rubin, CEO

Now on our podcast page – the second installment of the “Meeting the Prior Authorization Challenge” podcast series! The newest episodes of this free resource cover maximizing optimal staff productivity in the face of a changing prior authorization landscape. PARx Director of Operations and Training Rabia Kabeer is joined by a Nurse Practitioner and a Practice Manager to deliver valuable insights into how PA’s have evolved, the pain points associated with them and how to give your staff the tools to make the most of their already busy schedules.

Topics addressed in this podcast series are:

Episode Four: How is the prior authorization landscape changing?
PARx’s own Director of Operations and Training Rabia Kabeer kicks off the staff productivity discussion by explaining how prior authorizations have changed over the last decade. She also provides an overview of our recent innovation, GUEST PASS, which allows any provider to submit a prior authorization using the PARx Prior Authorization Support System (‘PASS’), without going through the registration process.

Episode Five: Saving time with prior authorizations
Nurse Practitioner Jennifer Gillis weighs in on increasing prior authorization requirements and how the fluid, easy-to-use PASS system has cut the time needed to process them by 20% for her practice.

Episode Six: How PASS improves practice workflow
Practice Manager Kathy Parish explains how prior authorizations previously were complex and hard to keep track of.  Now her practice uses the PARx Solutions platform PASS, streamlining and speeding up the process.

Take a listen, and let us know what you think! Have a topic you’d like addressed in a future podcast? Drop a line to ariane@warnerpr.com with your suggestion and feedback.

3 Reasons Why “Full Service” Matters in PA Management

Healthcare providers today have a range of options when it comes to managing the ever-increasing number of prescription prior authorizations (PA).  They may choose to “go it alone” – searching for the correct submission form, completing the form, submitting the completed form and following up with the plan (often by phone). They may opt to use a “form based” third party service to find and complete the correct form, followed by the burden of follow up with the plan falling on practice staff. Or, they may choose a “full service” PA management partner. I’ve referenced PARx Solutions as the premier full-service PA management partner in past blogs; now, let’s consider what “full service” really means, and why should it matter to providers and their patients?

1. Insurance Verification: I was recently at a pharma client sales meeting when a district manager approached me with a concern about our service. She informed me that one of the practices in her district had tried using PASS (PARx Prior Authorization Support System), but that all nine of the PAs submitted were denied due to “insurance not found.” Upon hearing this, I reviewed all of the PA submissions from the practice, and found that just three submissions were placed through PASS – and all three were approved. As it turned out, the nine denied PAs were submitted using a different service.

This unnoticed error isn’t unusual from a busy practice; we have found that nearly half of all PA submissions cite incorrect patient insurance information, often due to including the medical insurance information rather than the prescription plan. As a full-service partner, PARx calls the pharmacy to confirm the patient’s prescription plan coverage prior to submission, to ensure that the PA is routed to the appropriate plan. This in contrast to a form based provider, in which case the PA is submitted to the wrong plan and so denied for insurance not found – as was the case in this example.

2. Follow-up with the Plan: Plans don’t always act expeditiously with regard to PA submissions. Often, practices need to follow up with the plan to get an answer on a previously submitted PA, or to provide additional information. Calling a plan generally results in extremely long telephone hold times (we have found typical hold times ranging from 10 to 45 minutes) before the staff member has the opportunity to speak with anyone at the plan. Most practices cannot dedicate the resources to sit idly on hold, waiting for the plan to respond to their inquiries.  With a full service partner,  follow up is performed on behalf of the practice, saving significant time for practice staff and resulting in faster PA decisions.

3. Quality of Submission: Plans frequently change the PA requirements for specific medications, as well as the PA submission forms and the process for submissions. This can become confusing for practices and result in more time being spent on the submission process, as well as frequent omissions of key information. Full service PA management partners review all submissions for completeness and accuracy prior to submitting the request to the plan. This results in a higher quality submission, leading to more approvals and better workflow management for the provider.

When considering how best to manage the increasingly complex world of prescription PAs, consider using a full service PA management partner to ensure that more patients receive the medication their provider deems best for their treatment.

Be Our Guest! Introducing GUEST PASS

By Dan Rubin, CEO

In our latest feature update, we’ve just made our free service even easier to access for physician practices.  Introducing GUEST PASS, which allows any prescriber to use PARx’s Prior Authorization Support System (PASS), without having to go through the registration process.

GUEST PASS is an excellent solution for any provider currently using inefficient PA submission methods, who wants to see the benefits of PASS but without an up-front commitment. This is a significantly growing problem for practices, as evidenced by a May 2017 MGMA Stat poll which found 86% of respondents had seen an increase in PA requirements during the past year.  Some of these prescribers may not be aware of the difference PASS has made for many providers, their staff and in the end, their patients.

GUEST PASS can be easily accessed by following these simple steps:

  1. Go to www.parxsolutions.com, and select the Submit a PA option.
  2. From the Log-In screen, click on Not Registered? Continue as a Guest User.
  3. Enter the provider’s NPI number, then follow instructions to complete and submit a PA.

Once submitted, the PARx support staff will manage the PA on behalf of the provider. Providers will receive an email with a reference code allowing them to check on the status of the submitted PA, and they will be notified when the outcome is determined.

Practices can opt to continue using GUEST PASS or they can elect to become registered users by answering a few short questions, creating a username and password, and using PARx’s electronic signature feature to create an account that is immediately available for use.  Registered users have the benefit of being able to check the status of all submitted PAs, as well as the ability to upload chart notes to PA requests, and can easily enroll additional providers to their practice account.

GUEST PASS (along with our new, easier than ever registration process) opens the door for more prescribers to experience the benefits of PASS, thereby helping more patients receive their prescribed therapy, and improving practice management.

 So what are you waiting for? Be our guest!

New Podcast Series: Meeting the Prior Authorization Challenge – A Prescription for Patients and Physicians

By Dan Rubin, CEO

As part of our dedication to providing physician practices with the insights they need to lessen the impact of PAs on office workflow and most importantly, to better ensure that patients received the medications their doctors deem best for their treatment, my colleagues and I have unveiled a free podcast series entitled “Meeting the Prior Authorization Challenge: A Prescription for Patients and Physicians“. The series consists of short, insightful conversations with members of the PARx Solutions team, doctors, and practice staff.

Prior authorizations aren’t going away, so it is essential that physician offices empower themselves to better handle the process. Who better to hear from on PAs than doctors and practice managers managing this process on a daily basis? By giving a voice to their frustrations, we hope to raise awareness of the solutions PARx offers at no cost to physician offices.

Topics thus far addressed in the podcast series include:

Episode One: What is PARx Solutions, and why do I need it?
Yours truly launches the podcast series by explaining what prior authorization are and the challenges they raise for physician practices. I also provide an overview of the service provided by PARx Solutions is and how it helps improve practice workflow and patient access to prescribed medications.

Episode Two: Prior authorizations and ophthalmology
Ophthalmologist Dr. Bingjing Roberts weighs in on the importance of prior authorization within her line of medicine and highlights how working with a PA provider has been helpful in ensuring her patients receive the prescriptions they need.

Episode Three: A practice staff member’s perspective
Ophthalmic Assistant Jeanette Key explains how PARx Solutions’ customer service team is fundamental to her practice better ensuring its patients receive the medications their physician prescribes.

Take a listen, and let me know what you think! Have a topic you’d like addressed in a future podcast? Drop a line to ariane@warnerpr.com with your suggestion and feedback.

Pharmaceutical Representatives: Tips for Building Strong Physician Practice Relations

By Dr. Charles Gold, Optometrist, New York, NY

Doctors Shaking Businessperson Hand

When a pharmaceutical representative enters my office, I expect one thing: that they add value to my practice. Working with a pharmaceutical representative is all about building a relationship. We want to feel that you know our practice and our staff. We want to see that you have something to offer us – beyond free samples. For any pharmaceutical representative looking to better their physician practice approach, here are my top two tips:

Get to know the staff. Too often, pharmaceutical representatives walk into an office and head right for the doctor. The is not the right approach at all! Instead, take some time and get to know the practice staff. Be sure to write down every staff member’s name and maybe even a brief description if it will be helpful for you.

Then, the next time you visit the doctor’s office, review your notes and make a point of using their names in your conversations. This will go a very long way in standing out and making an impression on the people who work very hard – and are often the individuals entering the prior authorizations (PAs) for your prescriptions!

Be helpful and offer advice. This can be as simple as reviewing the office’s website or as detailed as providing a new vendor service to the office.

Consider this: it is becoming more and more difficult to run a practice, and prior authorizations are definitely among the time-consuming challenges we face.  If you offer a value add – such as a prior authorization service vendor – you’re likely to catch the office’s attention. Doctor’s offices are going to favor companies that work with PA service providers like PARx. They’re easier to deal with. They make getting PAs approved easier and quicker. And they help us keep our patients happy!

Plus, by offering a PA service provider, you as a pharmaceutical representative are opening the door to new information. Some of the best reps I see in my office are the ones who come in, say hello to my staff, maybe bring lunch, and check in to see how PAs are progressing in the office. Are they being approved? Which medications are most denied, and what are the common reasons given? By reviewing this information, the reps are able to learn more about our practice, They are able to offer insight and prove their worth to both me and my staff.

Today, in order to be truly successful in establishing a relationship with a physician practice, pharmaceutical representatives must add value!

A Prescription for Meeting the Prior Authorization Challenge

By Dan Rubin, CEO

prescriber-solutions

In this blog so far, you’ve heard our insights into how to best meet the prior authorization (PA) challenge – we hope you’ve found our posts to be relevant and helpful to your practice. Over the coming months, we’re going to add outside voices to the blog, sharing the experiences of physicians and their practice managers across different therapeutic areas. Whether you’re in an ophthalmology or optometry office, you’re an OB/GYN or a gastroenterologist, or another specialty, PAs are a pain point for which every physician practice can use a prescription!

As a sneak preview to this series, here are some examples of how taking on the PA challenge through partnering with PARx has helped physician practices, in their own words:

“I didn’t use to do a lot of PAs. But now, more of the medications I prescribe require them. I used to be like most doctors I know – if I knew a medication needed a PA I avoided it. The PASS system is good because PARx knows how to expedite the process. With PARx, it is much easier for my practice, and there is no cost – using PARx is a no brainer.” – an OB/GYN in Alabama


“Before we used PARx, we tried a PA service that just provided the forms, meaning that if the PA was denied or there was an issue, we had to call the insurance companies ourselves, which was time consuming and frustrating. I would rather go through gum surgery than do that again! Now, with the PASS system, our patients are getting what the doctor is prescribing more often and in a more reasonable amount of time.” – Practice Manager for an Optometrist in Massachusetts


“In the past, we were in a real bind when the prescription was denied for a medication for which there really was no substitute. Since we started using PARx, we see a lot more approvals, and our patients are really happy when they can get the medication they and the doctor want.  Plus, I and the rest of the practice staff have more time to help the patients in front of us instead of sitting on hold with the insurance company, where we would wait 15-20 minutes just to talk to a live person. On the PASS system, it takes a fraction of that time to enter all the information, and then their people take it from there. So much easier.” – Practice Manager for an Endocrinologist in New York City

Sound familiar? Stay tuned for more stories on how meeting the PA challenge is good for your staff, your patients, and your bottom line.

 

The Year Ahead: What’s On the PARx Horizon

By Dan Rubin, CEO

2017parx

“Listen to the voice of the customer.”  It is an age-old business adage and one that the best companies always take to heart.    Over the past several months, we have had discussions with dozens of physicians and their staff to understand how our service can help them save even more time, produce higher PA approval rates, and most importantly help their patients get the therapy that is best suited to treat their conditions.  When customers speak, we listen!

We are excited to announce several enhancements to our PASS system – many created in response to feedback from physician practices utilizing our PASS service –  that we will be rolling out in the first quarter, including:

  • Single-User, Multi-Physician log-in: Group practices will be able to designate PASS users who can submit prior authorizations (PAs) for multiple physicians in the practice under a single log-in.
  • Chart note uploads: Users will be able to upload chart notes directly into the PASS submission, eliminating the need to print and fax these separately.
  • Electronic signatures: Prescribers will be able to register for PASS and electronically sign their HIPAA Business Associate Agreement, enabling them to register and immediately begin to submit PAs.

PARx continues to add new sponsored products to our roster.  For example, we  have added new brands to our already comprehensive list of eye care products covered, and are significantly strengthening our roster of covered products in several other therapeutic areas including diabetes, GI, weight loss, and dermatology to name a few.

PARx is in discussions about partnering with multiple Electronic Medical Records (EMR) providers.  Our goal is to enable registered PASS users to initiate PAs from within their EMR, pre-populating the PA submission with information from the patient record.  For some large group practices, PARx will be fully integrating with their EMR to provide the most efficient and comprehensive PA service in the market today.

We highly value the trust that our users have placed in PARx, and we constantly strive to improve on our market-best PA service.  I would like to personally thank all of our users and wish each of you a happy and healthy holiday season and new year. We look forward to 2017 with enthusiasm!