How to Save Time (and Sanity) During Reverification Season
By Lacey Varnon, ADN, PACS, BCPA
Founder, National Society of Biologic Coordinators
This is the second installment in Lacey’s series on how to successfully navigate “The Blizzard” for reimbursement professionals. If you missed Part 1, check it out here.
Alarm clocks set, Starbucks on standby and Ibuprofen stocked… It’s GAME TIME!
(Cue hype music…)
One of the biggest mistakes we can make is to wait until January to start reverifications. While most insurance coverage changes start over on January 1st, there is so much that can be completed in the months prior to alleviate many stresses associated with the first of the year.
October-November:
- Send out letters to all biologic patients, reminding them to notify the office of upcoming insurance changes ASAP
- Post eye-catching signs around the office, also as a reminder to patients to notify office staff of any insurance changes
- Post another sign on the medication refrigerator that alerts staff members to double check for any insurance changes prior to injecting the patient
*The National Association of Medication Access & Patient Advocacy has a fantastic Blizzard Toolkit that I have lived by! The great resource is equipped with sample letters, signage, and an easy-to-follow checklist to make sure you are set for the upcoming year. Download your toolkit along with your complimentary membership at NAMAPA.org.
November-December:
- Send out any re-enrollment forms and financial consents that may be needed for copay or financial assistance and PAP re-enrollment, to ensure this information gets to the Hub prior to January 1st to help avoid a lapse in care
*Manufacturer Hubs shine the brightest this time of year. Utilization of automatic reverification for all your patients enrolled in the Hub will save your time and your sanity. It is important to remember this throughout the year. While you may feel it is not necessary to complete that enrollment form for your buy and bill patient, they must be enrolled in the Hub to be eligible for these services.
Reach out to your Field Reimbursement Managers to see what services are available to your practice to help with reverification season.
December:
- Payers will start to release their updated policies prior to the start of the new year
- Now is the time to review any upcoming changes to coverage and reimbursement policies
*Be not afraid… The hours of searching Google for updated coverage policies are over! Policy Reporter has improved the reverification season for Biologic Coordinators/Medication Access Specialists.
With the Policy Reporter PolicyCore Subscription, I can do a (very quick) search to my specifications. I type in the drug, select the payer, and search. For me, I am interested in the coverage and reimbursement policies associated with a particular drug and payer.
Then, I simply review the policies that populate from the search and move on to the next payer. Policy Reporter has an added feature that compares the updated policy with any previous policies on file. These changes are highlighted for you, so no more searching for important updates.
Sounds too good to be true, right? You just cleared a week off your calendar; time to go Christmas shopping!
Check out PolicyReporter.com to get started this season.
What tools do you use to survive the Blizzard? Send your favorite tips to info@NBCS.health and partners@policyreporter.com to help others that are prepping for the storm.
If you’re a reimbursement professional, go here to join our Policy Reporter Partners community! You can earn honoraria for sharing your knowledge, and learn best practices from your peers to help improve patient access and affordability.
