Revenue protection at UNC Hospitals, including Lineberger Comprehensive Cancer Center, is dependent on optimized drug reimbursement at its infusion centers. As pre-certification requirements expanded, the UNC Department of Pharmacy developed a closed-loop, pharmacy-managed, pre-certification and denials management program, serving as an innovative model that provides significant added institutional and patient value. This approach has helped to both mitigate institutional risk of revenue loss due to denied claims and alleviate patient distress due to the financial toxicity associated with treatment.
Christian G. Downs, JD, MHA, ACCC Executive Director; Ali McBride PharmD, MS, BCOP, ACCC President 2019-2020; Suzanne Francart, PharmD, BCPS, University of North Carolina Hospitals; Randall A. Oyer, MD, ACCC President-Elect 2019-2020
Suzanne Francart, PharmD, BCPS, Assistant Director of Pharmacy at the University of North Carolina Hospitals, shares the processes that her program implemented to improve operations and patient care
I think this award elevated the work we had done and made executive leaders across the system aware of our project. Although we had their support, receiving the award helped them understand that we truly did something innovative and with good outcomes.
Sherri Costa, MS, RN, AOCNS® Manager, Cancer Support Services, SEWI & Quality Improvement Coordinator, SEWI Cancer Care, Ascension SE Wisconsin Hospitals
Find the CANCER BUZZ podcast on Apple Podcasts, Spotify, or wherever you get your podcasts!
Oncology pharmacy has undergone a rapid transformation in recent years. On this episode of CANCER BUZZ, learn more about the role that oncology pharmacists play in cancer care and how that role is changing in the face of new therapies and the advent of value-based health. Discover how the University of North Carolina Hospital’s Department of Pharmacy developed a closed-loop, pharmacy-managed, pre-certification and denials management program to avoid passing surprise bills to patients and ensure financial stability for the cancer program.
Guests:
Relevant Content:
