Benefits of Outsourcing Field Reimbursement Services with CoverMyMeds
Explore how outsourcing Field Reimbursement Services enables pharmaceutical companies to break down medication access barriers to extend brand reach, gain payer insight and increase patient journey visibility.
Field Reimbursement Services involve the deployment of highly trained Field Reimbursement Managers (FRMs) who support healthcare provider teams. FRMs provide educational materials and practical guidance to help provider teams expedite prior authorizations, address claim denials and coordinate appeals processes.
For years, hub services have played a crucial role in helping providers navigate insurance hurdles so patients can access their medications. As the healthcare ecosystem has grown more complex, the need has emerged for on-the-ground support roles that can address localized challenges and offer assistance to healthcare providers. FRMs have stepped into this role, offering a level of hands-on support that goes beyond traditional hub services.
Hear more from Kimberley Chiang and Harith Jones (Director of Field Operations & Clinical Services at CoverMyMeds) on this topic at Informa Connect's Patient Support Congress on Nov. 21, 2024.
Not able to attend the conference? Sign up for our webinar on November 13, “Specialty Therapies and Field Reimbursement Services: Driving Better Outcomes for Brands and Patients.”
OUTSOURCE FIELD REIMBURSEMENT SERVICES WITH COVERMYMEDS
By outsourcing Field Reimbursement Services to CoverMyMeds, your pharmaceutical brand gains the flexibility to quickly scale teams of Field Reimbursement Managers throughout the product lifecycle. With specialized, regional payer knowledge, our FRMs are ready to hit the ground running to support both new drug launches and in-market therapies.
CoverMyMeds can launch your Field Reimbursement Services program in all U.S. states and Puerto Rico in as few as 60 to 90 days. Our flexible training model allows us to scale quickly to meet your changing needs.
When paired with our electronic prior authorization or hub solutions, our FRMs offer comprehensive visibility into the patient journey – tracking prior auth status and prior auth behavior allows us to support where it is needed most.
Quite simply, our FRMs are different than most. Extended brand reach, access to in-depth payer knowledge and increased patient journey visibility are just a few of our differentiators.
Insourcing vs. outsourcing Field Reimbursement Services
In-house hiring of FRMs allows pharmaceutical companies to maintain control over recruitment, training and team management. This can allow for deeper integration into company culture and support long-term knowledge building within the organization.
However, insourcing also comes with significant internal time commitments and fixed costs for salaries, benefits and training. Hiring in-house FRMs also limits the ability to scale teams up or down to support unforeseen challenges.
To stay flexible, pharmaceutical companies often opt for a hybrid model, maintaining an internal core team supplemented by outsourced FRMs. To help ensure faster time to value from your outsourced FRMs, look for a vendor with a proven track record in field reimbursement services.
EXTEND YOUR BRAND REACH AND CREATE EFFECIENCIES WITH BOOTS-ON-THE-GROUND
From regular calls with sales account management teams, to provider office field visits, to tracking and following up on individual patient progress, our FRMs fill skill gaps for our customers to support patients’ timely access to their medication.
During new drug launches – particularly for smaller brands – our services can be more cost-effective than hiring FRMs internally. For in-market drugs with high denial rates, our FRMs’ specialized payer knowledge can be especially helpful in supporting provider teams with appeals for complex cases, high-cost therapies or specific payer and patient populations.
Frequently Asked Questions about CoverMyMeds FRMs
1. What does CoverMyMeds’ FRM hiring process involve?
In our FRM recruiting process, we prioritize candidates with real-world experience, specialized regional payer and therapy area knowledge, and a commitment to continuing education and skills expansion.
2. How does CoverMyMeds’ maintain high FRM retention rates?
With a culture that supports continuing education and upskilling, as well as the backing of our parent company McKesson, we are proudly able to maintain an exceptionally high retention rate for our Field Reimbursement Managers. This helps us preserve continuity of service and deep institutional knowledge for our clients.
3. What type of training do CoverMyMeds’ FRMs have?
Our FRMs are trained in shared rules of engagement, compliance requirements, brand services, product and therapeutic area information, and market access resources, which provides our customers access to compliant support for prior auth pull-through and reimbursement support.
4. What therapeutic areas do CoverMyMeds’ FRMs have experience in?
With experience across a wide range of therapy areas and brands, our FRMs bring a wealth of knowledge to every client engagement. This robust knowledge enables our FRMs to train provider offices to understand and simplify payer processes.
ACCESS SPECIALIZED THERAPY AREA AND PAYER KNOWLEDGE
Managing the prior authorization process effectively can require time and knowledge of payer systems that many healthcare provider teams don’t have. This can be particularly true for specialty therapies, where complex requirements can create significant barriers to patient access.
With robust clinical and payer knowledge, our FRMs can support any therapy area and train provider offices to understand and simplify payer processes. The effectiveness of CoverMyMeds’ Field Reimbursement Services is evident in our results. When our FRMs are deployed, hub programs managed by CoverMyMeds see an average 8% increase in patient enrollment following a prior authorization denial.CoverMyMeds data on file, 2023 Our experienced FRMs gain real-time visibility into prior auth status when leveraging other CoverMyMeds solutions, another key differentiator for CoverMyMeds.
GAIN DEEP PATIENT JOURNEY VISIBILITY
Siloed hub and patient support services mean that FRMs often lack visibility into patient journey data. Working in tandem with other CoverMyMeds access solutions, our Field Reimbursement Services help overcome those barriers to support patients in accessing their therapies faster.
Our FRMs may have real-time, critical line-of-sight into the patient journey, including prior authorization status, benefit investigation/verification information, denials, appeals and prior auth outcomes. Empowered with this insight, our FRMs are equipped to intervene at the first indication of delay in approvals.
For example, visibility into denial reasons offers insight on why repeated submissions were not successful. Knowing what’s causing issues in advance means our FRMs can spend time with the provider more efficiently, addressing reported barriers to support decreased time to therapy.
Through data, CoverMyMeds can provide valuable insights into regional trends, payer behaviors and access challenges. This information helps pharmaceutical companies refine market access strategies and identify areas for improvement.
Because our FRMs are extensions of the brand, they also have in-depth knowledge of available affordability programs, and which programs would best suit specific patients.
Break down medication access barriers quickly, efficiently with CoverMyMeds Field Reimbursement Services
Each day, our FRMs lend their personal insight to help healthcare teams navigate complex reimbursement challenges. Their work is an example of how CoverMyMeds combines technology leadership with human insight and compassion to help ensure timely and affordable access to medication for patients.
By choosing CoverMyMeds, you're not just outsourcing a service – you're gaining a strategic extension of your team. Whether you're scaling up field reimbursement services or starting from scratch, we’re committed to helping your brand break down barriers to access and affordability.
Attending Informa Connect’s Patient Support Services Congress 2024 in Philadelphia? Don’t miss Harith Jones and Kimberley Chiang’s presentation, “Maximizing Success – the Role of Field Reimbursement Services in Launch Strategy and Beyond,” on November 21, 2024, at 11:45 a.m. Learn more about the event.
Not able to attend the conference? Sign up for our webinar on November 13, “Specialty Therapies and Field Reimbursement Services: Driving Better Outcomes for Brands and Patients."
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