June 5, 2017 (PRIMARY CARE OPTOMETRY NEWS) — PARx Solutions, a company that helps eye care prescribers get prior authorizations from insurance companies, has upgraded its platform by adding features to better aid prescribers, according to information from PARx Solutions. Read Article
Pharmaceutical Executive | Dan Rubin | May 4, 2017
Talk with busy physicians and you’ll soon hear about the ever-increasing difficulty in getting approval for the medications that they believe are most appropriate for their patients. For pharma marketers, a superior efficacy, side effect and dosing profile is a necessary start, and a favorable managed care formulary position can be another positive step toward commercial success—but, more and more frequently, a prior authorization (PA) request must be approved before a medication can be dispensed and taken by the patient. Read Article
By Dr. Charles Gold, Optometrist, New York, NY
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!
By Dan Rubin, CEO
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.
By Dan Rubin, CEO
“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!
Primary Care Optometry News, November 2016
Optometrists say they are providing better patient care by using a prior authorization service that facilitates patients receiving insurance coverage of necessary medications.
PARx Solutions’ free support system helps prescribers and their staff process prior authorizations (PAs) without having to call insurance companies and search for forms.
“For a practitioner, prior authorization is a frustrating and burdensome process,” Dan Rubin, PARx Solutions president and CEO said in an interview with Primary Care Optometry News. “We are trying to make sure patients can get the medication best suited to treat their condition. We want to remove hurdles and give doctors power and confidence to write the prescription and have a strong likelihood that patients can get the medicine.”
Harvey Richman, OD, FAAO, FCOVD, a PARx user and private practitioner from Manasquan, N.J., told PCON that this service helps him make better clinical decisions.
“You can request prior authorization in under 3 minutes, which gets medications to patients sooner,” he said.
Welcome to PASSing Thoughts, a series of expert insights into the prior authorization landscape, from the desk of Dan Rubin, President and CEO of PARx Solutions, the creators of the PARx Prior Authorization Support System (‘PASS’).
At the point of prescription, when physicians are choosing the medication they deem best for their patients, doctor and patient are on the same page. Patients want the treatment that can best address their condition with a successful health outcome and minimal side effects. They are relying on the expertise of their physicians, who are trained to make the clinical decisions as to the best treatments for their patients’ conditions. Seems to be a simple equation, right?
Unfortunately, there are roadblocks. In many cases, patients end up not being treated with the specific medication that their physician had prescribed.
One of the main reasons for this problem is that managed care plans are putting restrictions in place, often based on economic considerations rather than clinical benefits. In particular, a growing concern for physician practices is the need for prior authorizations (PA) – the requirement by a patient’s health plan to approve a specific medication for reimbursement, without which, many patients are unable to fill the prescription.
PAs have real impact on patients receiving the medication their physician deems best for their treatment: data suggests only 29% of prescriptions that require PAs are dispensed with the originally prescribed medication, and that only 60% are filled with any medication.
Primary among physician practice concerns regarding the PA process is the sheer volume of time required of practice staff (and sometimes the physicians themselves) to manage the PA process. In addition to completing an initial PA submission, health plans often require additional information or a resubmission of a second form. Then, when trying to contact the health plan directly, practice staff often experience long hold times and poor responsiveness. Many staff find the process to be a complex, frustrating experience and highly disruptive to their workflow.
Physicians utilizing the right PA service end up with more patients receiving the originally prescribed medication for their conditions and less administrative time spent on non-clinical activities in their practices. The “right” PA service is one that goes beyond simply providing a form to the practice. It is one that streamlines the process for the prescriber, provides a standard electronic PA process that eliminates the need to complete specific insurance forms, reviews PA requests prior to submission, follows up with the plan for a timely response, contacts the prescriber when additional information is required, manages appeals if required, and offers access to a call center staffed by responsive and well trained nurses and pharmacy technicians.. And last but not least, it is a service that provides this help and insight at no cost to the physician practice.
When the right PA service is employed, everyone wins: physicians, practice staff, and most importantly, patients.