To help relieve the burden of time-consuming insurance coordination, Accredo’s intake department performs a thorough investigation of insurance benefits for each patient, including:
- Contacting the patient or caregiver to verify insurance and/or pharmacy benefit information and to obtain any additional insurance information
- Verifying insurance and/or pharmacy benefits with the payor
- Identifying required documentation for prior authorization and requesting any additional information required by the plan
- Submitting the information for prior authorization (if permitted) or advising your doctor on how to request approval on a prior authorization (for those plans which require your doctor to personally request prior authorization)
- Communicating benefits information to you and your family, plus informing you of your financial responsibility
- File claim with the confirmed insurance program carrier
Once coverage is verified, you will be notified of the information obtained from your insurance company.
Accredo’s reimbursement department also manages and obtains necessary prior authorization verifications to treat new patients and to continue treatment of patients already on service. Accredo documents and manages all information gathered during the prior authorization process, as well as the completed prior authorization in our clinical documentation system. We will follow up on the status of your prior authorization until we receive a determination from your insurance company.