Many new long-acting factor products are now available for the treatment of bleeding disorders. These products offer flexibility and enhanced lifestyle for patients who wish to dose less frequently. However, payers have not wholeheartedly embraced all of the new factor products.
Behind the scenes, Red Chip is hard at work navigating the complex world of contracts and reimbursement to ensure your HTC’s Factor Program will be paid when you choose to prescribe these new products.
We are:
- meeting with manufacturers to track the release of products
- researching and understanding the ways distribution channels are shifting
facilitating ongoing discussions with payers on proposed reimbursement rates and authorization criteria (e.g. some products lack proper J-codes, some require a statement of medical necessity, etc.) - facilitating ongoing discussions with payers on proposed reimbursement rates and authorization criteria (e.g. some products lack proper J-codes, some require a statement of medical necessity, etc.)
- utilizing “Free Goods” programs offered by manufacturers to provide delivery of the new products while reimbursement issues are ironed out
It is best to investigate these processes before you start prescribing.
Please call Mary Ann Barth or Tanya Saenz (949) 223-9828 with any questions you may have about billing new products for your HTC.