Provider Services - Benefits for Your Patients, Our Customers

The A-Med Specialty Pharmacy Team works with you to help improve the quality and the cost of care by coordinating specialty pharmacy activities between the patient’s primary care physician, prescribing specialists and social worker. By providing ongoing support for patients with chronic conditions, together, we can achieve the best possible outcomes from their treatments.

Outlined here are the roles that each professional plays:

Reimbursement Specialist
A-Med has the capability to bill insurance providers electronically. A-Med accepts most insurance providers, Medicare and Medicaid. A-Med reimbursement specialists will streamline the claim process to insure prompt reimbursement for the specialty products provided by:

1. Verifying participant’s benefits and obtains prior authorization if required.
2. Determining the proper billing channel.
3. Coordinating benefits.
4. Helping to ensure claims submitted are paid, accurately and consistently.
5. Working with physician’s staff whenever a patient may need access to a Medication Assistance Programs that help uninsured or under-insured patients acquire vital medications.

Clinic Specialist
A-Med Specialty Pharmacy offers clinics the services of its Clinic Specialists during clinic hours. Upon the physician's or nurse’s request or authorization, the A-Med Clinic Specialist will:

For Medications

1. Assist with obtaining prior authorizations from health plans for patient medications.
2. Problem-solve with patients having difficulties with current pharmacy provider. Example: patient unhappy with current provider because they do not deliver medications, but knows of no alternative.
3. Address insurance problems and concerns and, if appropriate, coordinate transition to A-Med or a new provider. (e.g., if HMO not contracted with A-Med.)
4. Facilitate prescription and documentation requests required by patient's insurance carrier.
5. Provide patient follow-up when necessary.
6. Offer reverse consultation with doctor when patient confides new information to the Clinic Specialist. Example: patient shares they are not using a medication as prescribed by the physician.
7. Elevate continuity in patient-doctor/nurse-supplier relationship, providing to the patient confidence and high quality comprehensive care.

For Disposable Medical Supplies

1. Assist with obtaining prior authorizations from health plans for patient supplies.
2. Consult with patient to determine best product(s) for particular needs of patient.
3. Educate patient on proper use of approved product(s). (e.g., how to use a hydrophilic Intermittent catheter).
4. Problem-solve with patients having difficulties with current supplies. (e.g., patient having problems with external catheter but knows of no alternative).
5. Supply product specific insurance coverage guidelines and information to the patient to help them make informed choices between all available options.
6. Make available on the spot product samples.
7. Facilitate prescription and documentation requests required by patient's insurance carrier.
8. Address supply problems and concerns and, if appropriate, coordinate transition to A-Med or a new provider. Example: HMO not contracted with A-Med.
9. Provide patient follow-up long when necessary.
10. Offer reverse consultation with doctor when patient confides new information to the product specialist. (e.g., patient shares they are not cathing as often as prescribed by physician).
11. Elevate continuity in patient-doctor/nurse-supplier relationship, providing to the patient confidence and high quality comprehensive care.

Disease Specific Programs
A-Med Specialty Pharmacy offers medications and disease-specific care coordination to help promote consistency, quality, safety and clinical effectiveness for many key therapeutic categories, including:

HIV/AIDS Transplant Hepatitis C Crohn's Disease Hemophilia Deep Vein Thrombosis

Multiple Sclerosis Rheumatoid Arthritis Respiratory Syncytial Virus (RSV) Psoriasis Asthma Ulcerative Colitis

Cystic Fibrosis Growth Hormone Deficiency Cancer Gaucher Infertility Spina Bifida

Medications for the Whole Patient
At A-Med Specialty Pharmacy we believe in treating the whole patient. We do not selectively offer to provide one medication and deny others that may be prescribed. We offer a full range of medications customized to meet each individual patient’s course of treatment. Medications can be compounded as requested by the prescribing physician. Among these are:

Antiretroviral Drugs Hemophilia Factors Pain Management Fertility Agents Other Injectable Therapies

Enteral Nutrition Monoclonal Antibodies Chemotherapy Hepatitis Therapy Vitamins & Supplements

Immune Globulins (IVIG) Antibiotics Steroids Hydration Inotropic Therapy/Cardiac Care Medication