Let Us Worry About the Fine Print So You Can Focus On Your Health
Some of the most frequently asked questions we get are in regards to insurance coverage. It’s not uncommon for new patients to be wary or hesitant about seeking treatment with ContinuumRx or another home infusion provider due to uncertainties around insurance coverage. In some cases, patients even opt for hospital-based infusion versus home infusion, thinking it’s the more insurable option.
In the early days of home infusion therapy, this might have been true. However, the industry has come a long way in the past forty years, and insurance carriers now recognize home infusion as a safe, effective, and patient-preferred care method.
According to an article published by the National Home Infusion Association (NHIA), “Typically, commercial insurers reimburse home infusion at rates that are 40–60 percent less than the cost of providing care for those same patients at hospitals.”
At ContinuumRx, you might have heard us say that we’re passionate about supporting our patients through all phases of the healthcare continuum. Insurance is part of that continuum, and ContinuumRx provides dedicated support to reduce the insurance processing stress so our patients can focus on improving their health.
Keep reading for answers to some of the most common questions we hear around insurance coverage and home infusion with ContinuumRx.
Which insurance carriers does ContinuumRx accept?
ContinuumRx accepts nearly every insurance carrier. We even accept state Medicaid for out-of-state patients in emergencies. So, as long as the patient remains in the state while receiving care, their treatment with ContinuumRx will be covered.
At ContinuumRx, our goal is always to support patients the best we can, so while it’s uncommon, sometimes we are out-of-network for a patient’s coverage. If this situation arises and we cannot provide insured care, we still connect that patient with a home infusion provider who can benefit them.
What is the process like?
After a patient is referred to us, they are connected with an intake specialist who begins the process of gathering their insurance information. From there, we reach out to the patient’s insurance company and determine the exact benefits they have, and what their insurance will cover. The intake specialist will then break down the numbers for the patient, letting them know upfront how much will be covered and what they will need to pay out-of-pocket. We give a baseline, exact number to ensure that there are no surprises for the patient. Throughout the time of care with us, the patient will have the same intake specialist who knows their situation and whom they will have access to for any questions or concerns they may have.
“Our goal is to always serve the patient in good faith. We cut through the red tape and focus on patient advocacy. That’s what’s important, for both those we treat and our company as well.”Manuel Padilla, Vice President, Revenue Cycle at ContinuumRx
Advocating for patients is our business. It’s our mission to make sure that every patient feels like they have an ally in their infusion journey. While some hospitals and infusion sites make patients jump through hoops to get the information they need, at ContinuumRx, we consider ourselves more hands-on. The intake specialist will always take the patient’s call and answer their questions promptly; no hoops.
What if my insurance carrier pushes back?
While the insurance process is typically straightforward, we occasionally run into complications with insurance carriers. In this case, we will vet with the patient’s insurance carrier, relieving the burden and ensuring we are doing all we can to get them coverage. If a carrier tells us “no,” we never stop there. We make sure to advocate for our patients and always get answers to the “why” questions.
Does ContinuumRx offer financial assistance?
Even with insurance coverage, we know that healthcare expenses can take a toll on families. That’s why we offer both copay and deductible assistance for those who need it. Within our insurance department, we have whole teams dedicated to Patient Financial Assistance. We seek out patient payment assistance groups and plans to provide our patients with every tool that is at our disposal.
When a patient onboards their therapy with ContinuumRx, they’re getting more than treatment, but a team that’s dedicated to their health. Our commitment to our patient’s experience is in every aspect of our business. The way we vet insurance carriers and simplify the process for our patients is just another way we provide optimum care.
Do you still have questions about our insurance processes? Contact ContinuumRx today to learn how we can support you in your home infusion journey.
Corporate Office | Birmingham, AL
Two Perimeter Park South, Suite 260 East
Birmingham, AL 35243
Business Fax: 205-991-1501
Toll-Free Phone: 800-665-2850
Toll-Free Pharmacy Fax: 877-438-9380