Making it Easier on The Practice

Reimbursement Support

Helping patients begin therapy faster and reducing patient drop off once on therapy, we work with payers to confirm the patient’s coverage status, determine the best benefit and identify any potential hurdles to access

Making it easier on the practice

ActiveKey reimbursement services provide a variety of prior authorization support reducing administrative hassle in accessing. We have got hub experience in specialty pharmacy eliminating any risk of prescriptions “falling through the cracks” while our non-dispensing pharmacy status ensures seamless prescription fulfillment. With robust appeals support, physicians are more independent focusing on the patient instead of tracking down delayed or denied claims reimbursement.

Our site coordinators help to become an extended arm to provider’s team, with a single point-of-contact case management approach that streamlines the process

Working closely with your field teams, our site coordinators develop strong relationship with practices and establish regional expertise around payer trends.

Benefit Verification

ActiveKey reimbursement counselors are verification experts, well-trained for techniques of performing a thorough benefit verification. Using ActiveHub to ensure comprehensive benefit verification, our counselors examine and detail everything from coverage requirements to payment levels.

Billing and Coding

Our reimbursement counselors can provide reimbursement tools such as coding tip sheets, sample claim forms, and billing guides. Facilitating inbound inquiries regarding billing, coding, and the claim submission process is a core ingredient of our reimbursement support programs.

Patient Support

ActiveKey team members are well-trained in all areas relating to product support to address all needs of a patient through a single call. Each counselor is required to attend different pieces of training as customer service, disease-sensitivity, and product-information training ensuring readiness for launch.

Prior Authorization

Our goal remains to remove all the potential hurdles in the product access as in the process and our ActiveKey reimbursement counselors facilitate the prior authorization process on behalf of patient, supporting them through any required administrative paperwork.

We provide parameters of the authorization referral process, required forms and clinical criteria. And we facilitate communication between the provider, patient and payer.

Appeals Management

Basic front end counseling is very important in preventing denials, ActiveKey also offers support in a claim denial situation. Many of our reimbursement counselors have years of healthcare experience, including advanced graduate degrees or direct clinical experience. The amalgamation of education and experience, along with strong communication skills and technical writing abilities, lends itself to a successful appeal.

Researching requirements for patients whose claims have been denied are done by our Reimbursement Counselors and are ensured that payer forms are complete. We also follow up on submitted appeals until claim resolution.

Payer Policy Research

We can help providers research basic coverage information about key payers with which they work frequently. This research provides information around general payer policy on a specific product.

Surveillance

Our reports allow you to identify which payer accounts require communication, mentioning areas that are disconnecting, where the system is not considering claims that should be approved and where further payer education may be necessary.