Part B Pharmacy / Chemotherapy
With the ever-expanding arsenal of new medications and cancer therapies becoming available and treatment guidelines being constantly updated, getting insurers to cover these new and often costly treatments can be difficult. The complexities of some of the diseases that require these aggressive treatments can be overwhelming for authorization teams. There are guidelines frequently available, but even these can be easily misinterpreted or updates to coverage policies overlooked by your team or the payer pre-certification department.
The consequences of not getting these treatment decisions correct are immense. In addition, staying up to date on new medications and monitoring for changes in treatment guidelines is a must.
Having a partner with experience in interpreting those guidelines in a utilization management program can be hard to find. Whether you need routine assistance with problem cases and appeals or need a consulting partner to provide insight into the Part B approval process, the team at Cadenza Health has this experience and can help your organization meet the demands of this complicated area of health care.