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Insurance Reminders and Accumulator Adjustment Programs

By January 1, 2019January 17th, 2019News

January 2019 — It’s a new year…so that means reimbursement challenges aplenty for all of us! In addition to narrowed formularies and increased tiers for high-priced medications, many patients will also be faced with Accumulator Adjustment Programs. This means they will be required to meet their out-of-pocket minimum in addition to whatever a manufacturer’s co-pay assistance program may have already paid. This will have a significant impact on patients and their families, since it is a financial burden they may not have faced in the past.

We will be carefully reviewing all patients’ medical plans before their first factor orders in January/February. However, to help assure uninterrupted service, let’s work together on the following:

  • Please alert us to any insurance changes for patients on service with your 340B Outpatient Factor Program.
  • Remind patients to look for new insurance cards in the mail and to update their pharmacy as well. This allows us to confirm benefits before they need an order.
  • Let’s continue to help every patient sign up or renew their Manufacturer Co-Pay Assistance Program.
  • To help patients understand their options, you may want to direct them to educational and advocacy resources available through NHF and local foundations. Here is a brief video from Alliance for Patient Access: The Co-Pay Surprise.

We love working with your clinic, your patients and families. Let’s make 2019 the best year ever! If you have questions, please feel free to call Mary Ann Barth or Holly Frye at (949)223-9828.