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Providers

Provider Services

We are your trusted partner in patient care

We share your goal of providing patients with quick access to therapy and support that leads to improved outcomes. Offering frequent updates and clear communication, we work in partnership with you to meet your patients' needs and help them maximize the benefits of their therapy. 

Our process reduces administrative burdens and resolves access challenges so that you have more time to focus on patient care. 

Making administrative processes easier

Prior authorization and appeals

  • Facilitate the prior authorization process

  • Offer pre-filled prior authorization forms

  • Provide letter of medical necessity templates

  • Assist to the highest level allowed by the payer

Letters of agreement

  • Over 100 letters of agreement executed in the last 12 months 

  • If none of the pharmacies in a limited distribution drug network are in the patient's payer network, we can pursue a letter of agreement or out-of-network override

Our payer knowledge increases speed to therapy:

600+

payer contracts

68+

limited payer networks

47

exclusive payer networks

Helping your patients afford therapy

Benefit investigation and coordination

Taking a case management approach, we perform a complete benefit investigation to explore all potential sources of funding and coordinate patient benefits to expedite the patient’s start of therapy, including direct billing arrangements for secondary and tertiary payers.

Obtaining insurance approvals

Our pharmacy has extensive experience working with PBM and medical benefits coverage. We track all details of insurance and patient financial assistance approvals to proactively initiate a new prior authorization or funding application before the current approval expires. 

Securing financial assistance 

We facilitate patient enrollment in copay assistance programs and foundations, including online and temporary approvals to expedite the patient’s start of therapy and use a case management approach to secure long-term approvals.

Adherence support that improves outcomes

We take proactive steps to help patients avoid gaps in therapy and improve adherence by providing proactive refill management and lab reminders. Working in coordination with your practice, our clinicians educate patients on what to expect from therapy and the importance of therapy adherence. 

Our patients are adherent to treatment ~15% longer than other specialty pharmacies

Patient insights at your fingertips

Our industry-leading MyPathpoint Prescriber Portal provides unmatched transparency into the referral process. Offering real-time referral information, it allows the prescriber and our pharmacy to support patients with greater clinical coordination, ultimately improving adherence and outcomes.