Access

Benefit Investigation

On average, AssistRx performs 70% of benefit investigations electronically, allowing technology to drive processes and improve speed to therapy.

The Advanced Benefit Verification tool leverages multiple data sources and proprietary algorithms to provide immediate, expanded patient coverage results for all therapies in real time. Results include:

– Patient coverage
– Patient out-of-pocket cost
– Drug access restrictions
– Fill options for all therapies

If a benefit investigation can’t be performed electronically, our talented patient support services team leverages their experience working with payers and PBMs to quickly verify coverage.

Prior Authorization

The AssistRx platform leverages leading e-prior authorization partners, such as Surescripts Electronic Prior Authorization tool and other payer and PBM connections, to provide connectivity for near real-time e-prior authorization submission for more than 80% of payer covered lives.

Our e-Prior Authorization tool eliminates the submission of forms with missing, inaccurate or incomplete information.

Appeals

Our e-Prior Authorization solution includes electronic appeal support. Healthcare providers are empowered to initiate appeals through iAssist.

The AssistRx Patient Solutions team monitors the progress of a submitted prior authorization and intervenes when appeals and plan rejections become barriers to prescription fulfillment. Services include:

– Proactive prior authorization and appeal education by payer and region
– Guide healthcare providers through the prior authorization process to ensure form completion
– Serve as the single point of contact for healthcare providers during prior authorization and appeal processes
– Work with healthcare providers to submit appeals
– Provide thorough prior authorization and reauthorization follow-up services