Optimizing Specialty Pharmacy Referrals
One of the roles of specialty pharmacy is to deliver potentially life-altering and often complex therapies as quickly as possible. However, in the industry's current state, many specialty pharmacies experience lengthy, drawn-out, and complicated approvals that traverse various stakeholders with unique needs and requirements, multiple systems, and different people at different stages of the referral processFrom the prescriber to fulfillment, the referral process is subject to a number of exceptions and decision trees, typically containing multiple stages and passing through the hands of several entities. Intake, benefits investigation, prior authorization, financial assistance, and any denials and appeals may all be further complicated when one or more entities use fax transmissions that must be manually entered into a database to be passed along to the next entity.To streamline the process, preserve data integrity, and ensure that each patient receives critical treatment in a timely manner, today's specialty pharmacy can enlist the help of specialized tools and technology that help patient care coordinators and benefit investigators manage the referral process.Every pharmacy stakeholder encounters many challenges in the current referral process.Common challenges often include:
Ambiguity in referral status, which often occurs from disparate, unconnected solutions
Inability to seamlessly integrate with current systems, processes, and workflows
An influx in forms and paperwork that may be filled out by hand and entered into one or more systems
Data integrity compromise from manual entry mistakes, double-entry, lost or misplaced documents, and other human errors
A lack of organization and tracking that can lead to difficulty when reporting to key stakeholders
Data integrity compromise from manual entry mistakes, double-entry, lost or misplaced documents, and other human errors
A lack of organization and tracking that can lead to difficulty when reporting to key stakeholders
Blendcare is here to help make specialty pharmacy easier
Referral Management platform makes the referral process automated, easier, and more efficient. To help specialty pharmacies, referral management solution works to simplify the referral process, expedite each patient's time to therapy, and ultimately improve outcomes. This feature increases the visibility and integrity of data while improving communication and reporting between team members and stakeholders.Key features includes:
Integration with your existing workflow and solutions
Clear task structure with start and end times to facilitate communication
Status updates, tracking, and timeframe-specific reporting
Collaboration between multiple users on multiple systems
Robust data capture, and reporting for improved management of the onboarding process
Collaboration between multiple users on multiple systems
Robust data capture, and reporting for improved management of the onboarding process
Blendcare is committed to creating more value for its customers.
Don't lose referrals or critical information
Manage, follow up, and get alerts on patient benefits, re-authorizations needed, and moreBenefits Investigation
- Track and manage each referral status
- Report your pharmacy's turnaround time and no-go's
Prior Authorization
- Document and track status of prior authorizations, appeals, and reauthorizations
- Track appeal success rates of overturned prior authorizations
- Schedule reauthorizations to keep documentation up to date before needed refills
Referral Complete/No-Go
- Track and manage each referral status
- Create patient onboarding activities with an automated push for both patient care coordinators and clinicians
Reporting
- Ensure patients receive medications promptly
- Understand reasons behind referral no-go's and prior authorization denials