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Helping AMD Patients Obtain Financial Assistance

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Retinal practices typically don't seek opportunities to process additional paperwork. However, the use of forms to provide payment assistance to patients with neovascular AMD has emerged as a welcome activity in recent years. "Assistance programs help patients receive the best care available without concern regarding their payments," says Philip DeJesus, billing representative at Vitreous Retina Macula Consultants of New York. "The process can be time-consuming, requiring patients to provide personal financial information. However, the programs help relieve our practice of some of the burden of paying for the medications used in patient care."

Since 1985, when its first product was approved, Genentech has donated approximately $1.5 billion in free medication to uninsured patients through the Genentech Access to Care Foundation (GATCF) and $250 million to independent, non-profit organizations that provide co-payment assistance. Information on all of these programs is available through Genentech Access Solutions www.genentechaccesssolutions.com/
portal/site/AS
.

Making a Difference
"We inject approximately 4,000 anti-VEGF cases per year. Of that number, approximately 400 receive benefits from the Chronic Disease Fund, an independent non-profit organization that works with Genentech to support the treatment of AMD," says Jim Ohlenforst, ophthalmology manager at Charlotte Eye Ear Nose & Throat Associates, P.A. "No one goes without therapy."

"Our practice performs approximately 900 anti-VEGF treatments per month, depending on the conditions of various patients," says DeJesus. "Without the Genentech assistance program, a large number of these patients would receive an alternative treatment that may not be the first choice of the treating physician."

Vitreous Retina Macula Consultants informs patients of payment assistance through pamphlets. "The billing staff then helps patients complete the forms and faxes the forms to Genentech for processing," explains DeJesus.

Assistance applications require special efforts by staff. "We submit the forms immediately so patients know before their next visit whether they qualify for assistance," says DeJesus. "Helping the patient complete these forms, faxing them to Genentech and receiving confirmation that the forms were received takes about 60 to 90 minutes of staff time. It may take up to 48 hours to receive a response from Genentech. Keeping the patient's account active is an ongoing process."

At Charlotte Eye Ear Nose and Throat Associates, patients are educated about available options during the first visit when a physician and clinical staff member are present. "We ask the patient to complete the application in the exam chair while we have his attention," Ohlenforst says.

Dedicated Staff Are Key
Efficiency in assisting patients increases as staff members gain experience. "We have one full-time employee who's dedicated to processing paperwork and follow up with the Chronic Disease Fund claims management," says Ohlenforst.

"The most critical aspect of this process is having well-trained and dedicated office team members who understand the program and are able to effectively educate patients and work with them throughout the process," says DeJesus.

Assistance in Other Issues
Genentech's support extends to assistance in other issues, including inventory challenges and spoiled medications, which once resulted from a malfunctioning refrigerator, says Ohlenforst.

"Genentech has aided our practice immensely when it comes to managing our inventory," adds DeJesus. "Genentech provides the drug for our patients when insurance won't cover a non-covered diagnosis. If an insurance plan pays and later requests the payment back, the drug is replaced. If, for whatever reason, the drug becomes contaminated or the vial is dropped, then the drug is also replaced."

These types of programs are invaluable at a time when the AMD population is increasing and many patients are struggling financially.


Retinal Physician | 323 Norristown Road, Suite 200, Ambler, PA 19002 | 215-646-8700
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