Responsibilities

Outsourced Field Staff: Overcome Reimbursement Barriers

• Reduce pending, delayed, and denied claims by delivering training to a provider’s entire office staff. Provider staff turnover is alarmingly high, and many people besides the physician can impact patient access

• Remove most barriers to patient access by educating providers on local and regional payer issues, coding changes, appropriate claim submission, and correct utilization of patient assistance programs

• Improve OIG compliance by allowing sales representatives to focus on the clinical sell and not on reimbursement issues. Questions from providers are answered quickly and accurately because sales representatives have a singular point of contact for all reimbursement support needs

• Effectively present your product’s clinical, economic, and humanistic value proposition to payers

• Your outsourced team will meet one-on-one with payer decision makers, attend CAC meetings, interact with state Medicaid directors, and negotiate managed care contracts on a regional or national level

• Consistently monitor your product’s formulary position vis-à-vis competitors in the contractual market basket, and research communications from MACs, carriers, FI, and the VA/DOD for policy updates

• Provide strategic insight into how policy or contract changes could impact your product and what steps you can take to maintain or improve patient access

• Develop and implement health policy strategies with core advocacy groups. Create and execute detailed action plans for lobbying activities, and work with clients’ contracted lobbyists, corporate, and Political Action Committee (PAC) resources

• Improve relationships with pharmacy benefit managers, wholesalers, group purchasing organizations, distributors, and retail chain pharmacies to ensure adequate supply and seamless distribution of your product

• Negotiate distribution contracts, manage rebates, and ensure sales tracking