|
|
Renewing Co-Pay Assistance
Here's how to help your patients through the process —
and how to keep your practice organized.
By Sean McKinney, Contributing Editor |
|
|
|
Every year, hundreds of millions of donated dollars help defray patient co-payments for treatments for AMD and macular edema associated with retinal vein occlusion (RVO). But take note. You and your patients need to follow the proper procedures to obtain funding.
Greater Awareness
Andrew Antoszyk, MD, of Charlotte Eye Ear Nose and Throat Associates, says a complete understanding of the requirements is lacking. For example, many patients and practices believe co-pay assistance is effective for only 1 year. "These programs are renewable but may require a new application," says Arreka Hoover, Dr. Antoszyk's secretary. "It's imperative that each practice keep track of the patient's ‘anniversary' with a co-pay foundation to ensure that a new application is submitted in time for future therapies." She says her practice renews all patients at the beginning of the calendar year to avoid the risk of applications being submitted after renewal dates have passed.
Dr. Antoszyk adds that some foundations provide a fixed amount of funding each year, requiring a new application when base funding runs out.
"I can't emphasize enough the importance of keeping an Excel spreadsheet on a common drive that tracks each patient's foundation allotment. The spreadsheet must be kept up to date by a designated office staff member and should be accessible to the business office at all times," says Dr. Antoszyk. "This helps ensure that patients are covered and protects the practice against expenses that aren't reimbursed."
Patient Access Network (PAN) Foundation, a co-pay assistance foundation that provides assistance to wet AMD and RVO patients, communicates upcoming patient renewal dates to patients and providers. "Continuity of care is very important to PAN," says Korab Zuka, PAN vice president, External Relations & Operations. "Renewal patients aren't required to resubmit financial documentation unless their circumstances have changed substantially (i.e. income has changed more than 5%). Renewal applications are sent 4 to 6 weeks before their renewal dates to patients who are still active, meaning that a claim has been received during the previous 60 days or the patient or provider has informed PAN of a different treatment schedule that would affect the 60-day claim submission. This ensures our funding is channeled to the patients who need the assistance the most."
Mr. Zuka encourages the use of the PAN Foundation's provider portal (https://providerportal.panfoundation.org/), which allows providers to apply for renewal on their patients' behalf with a virtual signature feature. The system also allows access to their patients' grant balances and renewal dates 24/7. "The virtual signature capabilities allow us approve most patients by the next business day," he says.
When Documentation Is Missing
Dr. Antoszyk and Ms. Hoover also recommend that practices prepare to avoid missing documentation. "We ask patients to provide copies of their previous year's tax returns, so we can ensure they're forwarded to the co-pay foundations," says Dr. Antoszyk.
Also expect that some patients — particularly elderly AMD patients — will be reluctant to provide required financial information to strangers over the telephone when the co-pay foundation screens or enrolls the patients. "We provide a handout that includes the phone number and contact person at the foundation," he says. "This makes it a more trust-worthy process for them."
Typically, however, the renewal process proceeds smoothly.
"Renewal with PAN is streamlined, especially because the renewal application is prepopulated by PAN. The patient and physician only need to update information that may have changed," states Mr. Zuka.
| Co-Pay Foundations for Your Patients |
| • |
Chronic Disease Fund. Phone toll free: 1-877-968-7233 or visit their website at www.cdfund.org. Provides co-pay assistance for AMD and macular edema after retinal vein occlusion treatments. |
| • |
Patient Access Network Foundation. Phone toll free: 1-866-316-PANF (7263) or visit their website at www.panfoundation.org. Provides co-pay assistance for wet AMD and macular edema after retinal vein occlusion treatments. |
|
|
|
|
|
|
