A Day in the Life: Manual vs. Automated Patient Assistance Program

Are you tired of the tedious and time-consuming process of manually searching for patient assistance programs? Searching for programs on search engines or spreadsheets can often lead to inaccurate or irrelevant results, and relying on outdated forms can result in program denials. Fortunately, there's a more efficient solution. By using a technology platform, you can quickly find the right assistance programs for patients and feel confident the program information is always up to date. Matching patients to programs become a breeze as the technology reviews eligibility criteria and provides instant results. Enrolling patients becomes simpler too with digital document retrieval and electronic signatures. Tracking and managing patient enrollment becomes seamless, reducing the risk of missed opportunities. Say goodbye to manual headaches and hello to a more efficient and effective process for assisting patients in need. Check out the evaluation of a manual vs automated tool below.    

1. Patient identification and program eligibility

Manual:

Identifying patients can be a challenging task since not all patients are upfront about their ability to pay. In some situations, providers wait for a patient to ask for financial assistance whether that be a payment plan or charity care. Since most patients aren’t aware that patient assistance programs exist and it’s uncomfortable to acknowledge you need help, most will not ask for assistance.  

Additionally, searching for programs online is a tedious and sometimes misleading process. Search engines often populate results based on sponsorships or paid ads as opposed to what is the most accurate information. For example, searching for assistance on a specific medication could lead you to a program for a biosimilar or related drug, but not the one your patient needs.  

Patient assistance programs also change their eligibility criteria frequently. If you are pulling the application or relevant documents from a third-party website instead of directly from the manufacturer portal itself, you’re likely to complete a form that is outdated and will be discarded by the program. If you’re unfamiliar with the criteria that allow a patient to be eligible for an assistance program, it can make the searching even more difficult. Additionally, reading through the lists of requirements and eligibility criteria is no quick task, especially if you are helping multiple patients.

Automated:

Technology can easily and quickly identify patients in need. This enables patient advocates to see every opportunity available, so that they are able to help more patients and collect more reimbursements. A comprehensive database provides a quick guide to all assistance programs available for a certain medication as well as funding for specific diagnoses. Additionally, the database is updated continuously so applications and related forms are always current, eliminating program denials due to incorrect forms or documentation.

Also, technology can efficiently evaluate program eligibility criteria and match patients to the most appropriate programs in the database. This helps patient advocates make the best decisions for their patient’s specific situation and turns an hours-long process into a matter of seconds.

2. Application and enrollment workflow:

Manual:

Enrolling patients into patient assistance programs, specifically for free medications, can require additional documentation such as proof of income, as well as signatures from the patient and the provider. It can be burdensome to the patient to ask them to come into your facility just to bring documents and sign paperwork. However, if you wait until the patient shows up for their treatment visit before obtaining the documents and signatures, it can be too late to get their initial visits covered.  

Additionally, after obtaining all required documentation and consent, faxing multiple pages to the program is a cumbersome, time-consuming process. Nothing is more frustrating than receiving a program denial due to lack of funding because the process took too long.  

Automated:

Utilizing a secure electronic platform allows patient advocates to request signatures from patients and providers, obtain program deliverables, and store them in an easy and efficient manner. This also enables patients the ability to take photos of documents and provide electronic signatures from the comfort of their home, instead of traveling to their provider’s facility. This process not only improves the patient experience but decreases the time from application start to submission and approval.

3. Enrollment and re-enrollment status and tracking

Manual:

Maintaining a patient’s enrollment once they’ve been approved for a program is arguably more difficult than the initial enrollment itself. We’ve seen countless patient advocates utilize Excel spreadsheets, calendars and notebooks to track the submission of payment requests or order free medications for their patients. The first quarter of the year is even more daunting since that is when most re-enrollments occur.

Every program’s re-enrollment period is very different, so while some program enrollments may expire at the end of the calendar year, some are based on a rolling 12-month period. And some programs expire after a multi-year term. Therefore, accurately tracking a patient’s program re-enrollment can be the difference between a patient missing their first treatment of the new year when deductibles are at their highest and coming into their first visit confident that they can afford their upcoming treatments.  

Automated:

Automatically tracking all relevant visit dates for enrolled patients through technology is incredibly powerful. This provides clear visibility into payment requests, medication orders to be submitted and requests for those submitted but not yet complete. This ensures patient assistance is applied timely for all eligible encounters and allows patient advocates the opportunity to support more patients.  

Additionally, all program enrollment and expiration dates are recorded and stored in a worklist. This identifies those patients whose enrollment is expiring so no enrollments lapse. For those that are expiring, automated alerts keep the patient advocate informed so that no patient has a lapse in treatment.

In conclusion, embracing automated technology in the search, matching, enrollment and tracking of patient assistance programs bring numerous benefits to patient advocates and their patients. By eliminating the manual and time-consuming aspects of program search and enrollment, patient advocates can focus on providing the best support to their patients. The use of comprehensive databases, real-time updates and secure electronic documentation transfer streamlines the entire process.  This ensures accurate program matching, simplified enrollment and seamless tracking of patients' program status. Ultimately, this leads to an improved patient experience, reduced administrative burden and an efficient delivery of patient assistance. Supporting patients’ ability to access and afford healthcare ultimately improves overall health. With automation, patient advocates can navigate the complexities of patient assistance programs with ease, allowing them to make a real difference in the lives of their patients.