Improve the specialty pharmacy patient journey from diagnosis to treatment

Trust is the foundation of any successful relationship. It is especially important between a patient and a healthcare provider or pharmacy. Requiring and receiving care is a vulnerable position for patients to find themselves in. That’s why it’s crucial for providers and pharmacies to answer their questions and give them confidence in their course of treatment.

In the pharmacy industry, questions usually arise when a patient receives a prescription that isn’t available at the corner drugstore.

What is a specialty pharmacy?

When a patient is diagnosed with a new, complex condition, or if a current treatment plan isn’t working, a prescription from a specialty pharmacy may be the next step.

Specialty pharmacies differ from a standard retail pharmacy in that they formulate and/or carry different classes of medications to treat complex or rare conditions. These medicines may require special handling, storage, and/or dosage instructions.

To avoid confusion or frustration, providers should explain this to patients upfront. What happens next will impact the experience for both the patient and the pharmacy.

How does it work?

Filling a prescription is more than just sorting pills into a bottle. It starts with verifying a patient’s medical history, previous treatments, allergies, and more to prevent dangerous drug interactions.

Next, the pharmacy must verify eligibility and insurance coverage to ensure timely payment following the transaction. If a prior authorization is required, it is completed by the pharmacy, and depending on the process in place, may or may not include communication with the patient.

As the prescription nears completion, the pharmacy must perform safety checks and update inventory accordingly. In the case of a specialty pharmacy, a patient care coordinator will call the patient to discuss the treatment plan, provide instructions, and answer questions.

Creating a specialty pharmacy workflow that works 

Given the many steps and tasks associated with a single prescription, it’s easy to imagine how any number of things could cause an error, delay, or bottleneck in the process.

Inovalon’s ScriptMed Specialty was designed with a specialty pharmacy’s workflow in mind. It’s a scalable, end-to-end software solution that streamlines each task from prescription receipt to fulfillment, improving:

• • Patient management
  • Claim adjudication
  • Clinical management
  • Inventory oversight
  • Revenue cycle management

Along the way, it automates many time-consuming tasks, like compiling a complete patient profile and verifying benefits.

With real-time access to the industry’s largest primary source dataset, pharmacies can be confident that their data is complete and accurate. And through ScriptMed’s many APIs, most prior authorizations can be handled without involving (or bothering) the patient.

With a seamless process in place, pharmacists can work faster and help ensure timely payment, and patients can begin treatment sooner and start feeling better faster.

Discover how ScriptMed can benefit your specialty pharmacy and transform your workflow.

Inovalon and design^® and Inovalon^® are trademarks of Inovalon, Inc.