"You find coverage patients didn’t even know they had."
—A nurse from a leading clinical practice in North Carolina
Frequently Asked Questions
Why should I choose a specialty pharmacy when my patients can drive to a retail pharmacy in their neighborhood?
Specialty pharmacies handle medications that are considered the most complex for patients and require special handling. So working with a specialty pharmacy that is trained to handle these medications makes it easier on you. We also keep ample stock of these complex medications available, so your patients can get started on treatment a lot sooner. Our pharmacy team can also help to facilitate Prior Authorization, conduct a full benefits investigation and provide patient education. Our pharmacists and nurses are available for around-the-clock emergency clinical support.
How does your pharmacy make a difference in patient care?
Our dedicated pharmacy team contacts your patients each month to help them stay adherent to their medications. We develop trusting relationships with patients, and offer support to keep them adherent to the treatment plan you have developed. Over time, our Patient Management Programs have demonstrated a positive impact and the ability to make a difference in the quality of disease outcomes by working in partnership with you. Patients respond well to our services, reporting a high overall satisfaction rating.
If I send in a referral for a specialty medication, and you discover a PA is required, how soon will I be informed?
As soon we learn that a PA is required for processing your patient’s prescription, we will contact you. Usually you can expect a call back from us in less than 24 hours after submitting a prescription to our pharmacy.
Will you manage the PA process for me?
Insurance companies and third party payers vary significantly in their PA practices and policies, and usually their policies don’t allow us to complete the entire process on your behalf. Whenever allowed by the insurance carrier, we will initiate, facilitate and manage the process for you, including getting the appropriate forms that need to be submitted and completing as much of the demographic and clinical information as we have available, before faxing it to you for approval. In some cases, the doctor’s office is required to request the PA form directly, or it must be completed online or via telephone by the doctor’s office. In these cases, we will notify you immediately, and provide as much support and information as we can, to help save you time and make your job easier.
What do I do once I complete the PA?
You can fax it to us at 800.218.3221 and we will submit the PA form to the insurance company for you. Be assured that we will work through the process to ensure that the prescription is completed and delivered to your patient.
What if I want to process the PA myself?
We are happy to work with you and provide as much support as you need, in order to make your job easier. We simply ask that you please forward to us the prescription order and indicate that you have already submitted the PA.
Do you offer Saturday delivery for our patients?
When necessary, we can provide for Saturday delivery. We sometimes suggest avoiding Saturday deliveries, because the level of service can differ in certain areas. We prefer to have the prescription delivered to the patient during the week, to ensure they receive their medication based on the start date, to help keep patients adherent to the medication schedule.
What insurance plans do you accept? How do I know which to send to you?
Because a patient’s pharmacy benefit can vary greatly within any given health plan, it is difficult to provide a complete and accurate list of all the insurance plans we accept. Generally, we are in network for all of the largest pharmacy benefit managers, and can work with most health insurance plans.
We appreciate your referrals and value your confidence in our services. If we cannot fill a prescription, we will refer your patient and their prescription to a designated specialty pharmacy and communicate with you via fax.
Does my patient have to be there to sign for the prescription when it is delivered?
That is not necessary. Before shipping any order (new or refill) we will always contact each patient to confirm the delivery date, and agree on a safe place to leave the package, so that they can easily retrieve the delivery, on time.
How will you request refill authorizations from our office when a patient is in need?
We will fax you a refill authorization request. Once we have the necessary information, we will fill and ship the medication to your patient. We will also contact the patient, to determine his or her medication needs and their adherence to medication as prescribed.
Do I need to use your fax referral form?
No. We provide these customized referral forms simply for your convenience and to make your job easier. We will gladly accept your own prescription order. To complete the order, we will need the patient’s pharmacy benefits and contact information, which you can fax to us along with their prescription. For your convenience, we can provide fax cover sheets to make it easy for you to refer patients to our pharmacy. Our pharmacists also accept telephone orders.