• Reimbursement service provider was unable to handle rapidly increasing case volume resulting in need to transition to a new vendor
• Coverage from public and private payors was low due to lack of education and limited publications regarding the product

• Premier Source developed an implementation plan and oversaw the transition of services to a new reimbursement provider
• Premier Source developed processes, SOPs, and oversaw the development of a new case management application to ensure that the new vendor could handle the increased case volume.
• Premier Source established a program focused on appealing denied claims and working with client managed care resources to identify payors to eliminate barriers to reimbursement.

• Seamless transition of reimbursement services to the new service provider has enabled the client to broaden their reimbursement service offerings while handling a significant increase in case volume.
• Client has leveraged our work on appeals to secure contracts with numerous public and private payors resulting in a significant increase in coverage

Case Study 2:

• Manufacturer sought to develop a reimbursement strategy in preparation for the launch of their new product which was entering a highly competitive market where most products have significant reimbursement support programs in place.
• Company desired to offer comparable if not superior reimbursement services.

Actions Taken

• Premier Source analyzed the current reimbursement offerings provided by major competitors and developed a summary of key features that were necessary to succeed in this market.
• We developed a suite of potential models that met business requirements outlining the pros and cons of each model. We also assisted the client in selecting the optimal model for their product needs.
• We designed and launched a reimbursement assistance and patient support center responsible for managing relationships with physicians, patients, and distributors.

• Premier Source and the manufacturer collaborated and successfully implemented a reimbursement strategy which offers more comprehensive services than most competitors.
• Client staff and customers have given the reimbursement program positive reviews highlighting its ability to keep patients and physicians up to speed on the status of cases while expediting the process to get patients on therapy

• Manufacturer sought to expand the services provided to assist patients with gaining access to therapy and improve the overall level of support and communication.

• Premier Source conducted workshops with client staff to map out the current processes and identify gaps and opportunities for enhancement. We then developed new processes, SOPs, and a communication strategy.
• Premier Source agreed to take over administration of the program and developed and implemented a comprehensive transition plan to ensure the seamless transition of the program from the previous vendor.
• Premier Source worked with the manufacturer to establish a new program including SOPs, product, process, and disease state training, and new technology resources that could easily be modified and applied to future products.

• Premier Source has successfully secured coverage for many patients who had previously been encountering significant challenges getting on therapy.
• New processes, technology resources, and a communication plan have enabled client staff to get more frequent case updates and improve monitoring of issues encountered by patients.
• The manufacturer now has a highly scalable reimbursement/patient support program in place to accommodate future product launches.

• Strategic Reimbursement Planning & Consulting
  
  
• Reimbursement Support Programs
  
  
• Patient Assistance Programs
  
  
• Appeal Assistance Programs
  
  
• Alternative Coverage Programs
  
  
• Monitoring of Changing Legislation
  
  
• Market Watch and Educational Seminars
  
  
• Patient Compliance Programs
  
  
• Product Specific Hotlines