A premier provider of Reimbursement Services that strives to assist patients and their families with securing insurance coverage for Humatrope growth hormone therapy.
Who is Humatrope DirectConnect.
100
What is a Patient Service Liaison.
A customer focused, single point of contact providing step-by-step guidance to patients and physicians
100
Obtains benefits information and updated the Payer Coverage History and insurance screen with the details
Who is a Benefits Investigator.
100
These are used to record Humatrope benefits details
What are the BI worksheets.
100
Experts specializing in benefits verification, prior authorizations and appeal services
Who are Benefits Investigators.
200
What are ISS, Growth Hormone Deficiency, Panhypopituitarism, Hypopituitarism, SGA, SHOX, Turners
FDA approved indications for Humatrope.
200
This is completed when a patient is 18 years of age or older
What is a Medicare Eligibility check.
200
This must be completed for a current HDC patient prior to the BI Rep faxing the BI Summary Report to the HCP's office.
What is a Recertification call.
200
This is completed when the pharmacy copay is greater than $200 or the pharmacy does not provide coverage
What is the BI worksheet.
200
The process of following up on the first authorization decision with a payer.
What is a PA follow up
300
This document provides HDC with permission to release PHI.
What is the Patient Authorization form.
300
This is obtain when determining a Patient's eligibility for the Temporary Medication program
What is a Patient Certification form
300
These are good for one year and should be submitted along with the Prior Authorization forms and prescription when requesting coverage from a payer.
What are medical documents (clinical notes).
300
This payer does not speak with third parties and the PA forms do not require a signature
Who is Cigna.
300
A team of nurses responsible for drafting and submitting appeal letters.
Who are the Appeals Specialists
400
Patients that are not eligible for TMP.
Who are government beneficiaries.
400
This is required prior to offering Injection Training services or shipping a Starter Kit
What is a Marketing Consent.
400
A scan completed of the left hand of a Pediatric Patient
What is a Bone Age Report
400
An entity whom HDC provides benefits details and assists with coordinating medication shipments for patients
What is a Specialty Pharmacy.
400
This occurs when coverage options have been exhausted and TMP ceases.
What is a PAP Referral (Lilly Cares Referral)
500
These six pieces of information are required for an SMN to be considered complete.
What are the Patient Name, Patient DOB, Diagnosis, Prescription options, Physician's signature and the Physician's signature date.
500
This case is used to obtain consent, but is closed after 30 days of the patient being non-responsive.