Comprehensive Drug Reimbursement Services
Our regulated health professional team provides end-to-end drug reimbursement services designed to optimize patient access while minimizing administrative burden. Whether you need support for individual cases or ongoing navigation services, we deliver clinical expertise and proven results.
Complete Navigation Solutions for Healthcare
Drug reimbursement navigation isn't just about filling out forms it's about understanding clinical rationales, regulatory requirements, and system workflows that determine patient access to essential medications. Our regulated professionals bring this comprehensive expertise to every case.
Core Reimbursement Services
To bridge the gap between complex drug reimbursement systems and patient access through professional healthcare navigation.
Benefits Verification & Eligibility Assessment
- Private Insurance Plans: Complete benefits analysis and cost estimation
- ODB/Trillium Drug Program: Eligibility confirmation and coverage assessment
- Federal Programs: NIHB, VAC, WSIB, IFHP verification and coordination
- Real-time Cost Estimates: Patient out-of-pocket calculations and alternatives
Average turnaround: 24-48 hours | Success rate: 98%+ accurate estimates
Prior Authorization Excellence
- Form Completion: Comprehensive PA applications with clinical rationale
- Clinical Criteria Preparation: Evidence-based documentation and support
- Insurer Follow-up: Proactive communication and status tracking
- Approval Optimization: Maximizing first-submission success rates
Average approval time: 40% faster than industry standard
Ontario Exceptional Access Program (EAP)
- Full Submission Coordination: End-to-end EAP application process
- Physician Collaboration: Direct coordination with prescribing physicians
- Status Monitoring: Real-time tracking and proactive follow-up
- Renewal Management: Seamless continuation of approved therapies
EAP Success Rate: 78% first-submission approval
Appeals & Resolution Services
- Private Payer Appeals: Strategic appeal development with clinical support
- Public Payer Challenges: EAP denials, formulary exceptions, compassionate access
- Multi-level Appeals: First-level through external review coordination
- Success Tracking: Detailed outcome reporting and optimization
Appeal Success Rate: 85%+ successful reversals
Financial Assistance & Cost Relief
- Copay Card Programs: Manufacturer support identification and enrollment
- Bridging Supply: Temporary coverage while awaiting formal approval
- Patient Assistance Programs: Comprehensive manufacturer PAP navigation
- Multi-payer Coordination: Primary/secondary benefit optimization
Training & Workflow Optimization
- Standard Operating Procedures: Custom SOP development for your organization
- Staff Training Programs: Hands-on education for your team
- Template Development: Customized forms and workflow tools
- Process Optimization: Continuous improvement and efficiency enhancement
Flexible Service Models
Case-by-Case Support
Monthly Retainer Programs
Getting Started with Professional Navigation
Our regulated professional team is ready to assess your specific navigation needs and recommend the optimal service approach. Every engagement begins with a confidential consultation to understand your challenges, current processes, and desired outcomes.
Ready to optimize your drug access process? Contact our regulated health professional team for a consultation tailored to your specific needs. All discussions remain confidential under professional practice standards.
Testimonials
What our clients have to say
Even the all-powerful Pointing has no control about the blind texts it is an almost unorthographic life One day however a small line of blind text by the name of Lorem Ipsum decided to leave for the far World of Grammar. The Big Oxmox advised her
Tyler Morgan
