Financial Advocacy & Patient Assistance Resources

The Wisconsin Association of Hematology and Oncology (WAHO) is committed to providing physicians and their patients with the tools they need to navigate the complexities of paying for cancer treatment. Below is a library of resources provided by WAHO and the Association of Community Cancer Centers (ACCC) to help the multidisciplinary cancer team integrate financial health practices and help patients gain access to high-quality care.

In January 2022, ACCC upgraded its Patient Assistance & Reimbursement Guide print publication to a searchable, digital format!

You can now find the most up-to-date information on oncology assistance and reimbursement programs by searching for a prescribed product or company name, then further streamline your search by applying coverage and assistance-type filters.

Access details on all available financial assistance and reimbursement program benefits, application information, and eligibility criteria. Listings include direct links to external websites and company phone numbers and will be updated in real-time, so you’ll always have access to the latest information and external program links.

The digital Guide links directly to the ICD-10 codes website and the Library of NCCN Compendia for current indications. These resources were identified by ACCC members as the most up-to-date and authoritative source for this information.

ACCC Digital Patient Assistance & Reimbursement Guide

Financial Advocacy Playbook

The ACCC Financial Advocacy Network brought together experts in financial advocacy to create this Playbook—a comprehensive tool to support onboarding and continuous learning for staff who deliver financial advocacy services. In it you will find the basics of financial advocacy, including common terminology and definitions, and details on benefits verification, financial distress screening, prior authorizations, insurance education and optimization, and how to secure available financial assistance options for qualifying patients..
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Financial Advocacy Toolkit

ACCC, its members, and partners have collected new and updated resources to help you develop, implement, and continue to deliver effective financial advocacy services in your cancer program or practice. These resources include guides and tools for building financial advocacy programs, communicating with patients, screening for financial distress, optimizing insurance coverage, performing prior authorizations, handling denials and appeals, and so much more.
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Financial Advocacy Bootcamp

The ACCC Financial Advocacy Boot Camp offers powerful training to boost Your financial navigation services. Two sets of dynamic online courses offer the tools your staff needs to help patients pay for treatment—while maximizing reimbursement at your program. Free registration is a benefit of IOS membership.
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Patient Assistance Brochure

Dealing with a cancer diagnosis is stressful enough without having to worry about how to pay for treatment. This patient-facing brochure provides your patients with easily digestible information for exploring financial assistance programs through drug manufacturers and nonprofit organizations.
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Financial Advocacy Services Guidelines

The ACCC Financial Advocacy Services Guidelines address the critical need for early intervention by financial advocates to mitigate the financial burden of cancer. Whether your program is already providing financial advocacy services or is just in the planning stages, these guidelines offer the structure and support needed to advance your work.
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New Administration Opens ACA Marketplace for Special Enrollment Period

By Kristin Marie Ferguson, DNP, RN, OCN
February 16, 2021

Update, 3/24/21: The Biden Administration announced on March 23 that it will extend the open enrollment period for an additional three months, until August 15, to allow more Americans an opportunity to enroll in or change their plan.

On February 15, 2021, the U.S. Department of Health and Human Services took an important step in broadening access to health insurance coverage by opening healthcare.gov for a special enrollment period that runs through May 15, 2021. Healthcare organizations and patient financial advocates are praising this executive order by President Biden, which is coming at a time when many have lost their jobs and subsequently their employer-sponsored health insurance. Many states that operate their own websites to enroll residents in the healthcare exchange have also opened.

“By opening the health insurance marketplace, President Biden is providing our patients with options they did not have available to them before,” says Lori Schneider, chair of ACCC’s Financial Advocacy Network and oncology operations manager at Green Bay Oncology. “It is imperative that all cancer centers review and discuss these options with their patients to help prevent financial toxicity.”

Biden’s executive order will open the Health Insurance Marketplace for the states that use the federal marketplace website (healthcare.gov) for enrollment. To help ensure all people are aware of and have access to healthcare.gov, the Biden administration has directed federal agencies to review any policies that may make it more difficult for people to enroll in Medicaid programs.

Having access to primary and preventive health services are essential to expanding access to cancer screenings, which have seen a steep decline since the dawn of COVID-19. The Kaiser Family Foundation estimates that nearly 9 million uninsured Americans may qualify for free or subsidized health insurance with the opening of the Affordable Care Act Marketplace.

“During these turbulent times, it is especially important that our patients have various avenues to obtain healthcare coverage,” says Francinna Scott-Jones, ROCC, CPAR, financial coordinator at Northside Hospital in Atlanta, GA. “Being diagnosed with cancer can be devastating, so knowing you have an additional resource to obtain adequate insurance coverage can decrease some of that anxiety.”

ACCC’s Financial Advocacy Network is committed to reducing the financial toxicity patients face while undergoing treatment for cancer. We regularly produce timely tools and resources for financial advocates that can help them better assist patients who need help applying for insurance, reducing the amount of their copays, and obtaining the best care. The Congressional Budget Office (CBO) projects that the number of people employed will not return to pre-pandemic levels until 2024. Financial advocates for those with cancer are watching closely to see what new initiatives the Biden Administration will put forth to improve the quality of cancer care and address the financial toxicity that many with cancer face.

Additional information can be found at:

FACT SHEET: President Biden to Sign Executive Orders Strengthening Americans’ Access to Quality, Affordable Health Care

Kristin Marie Ferguson, DNP, RN, OCN, is the Senior Director of Cancer Care Delivery & Health Policy at ACCC.

Publications

Fighting Financial Toxicity
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Making-Case-for-Hiring-Financial-Navigator-100x130 Making the Business Case for Hiring a Financial Navigator
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From Oncology Issues

How Do You DISCO?
Lauren M. Hamel, et al.

Leveraging the Discussions of Cost App to reduce financial toxicity and improve treatment cost communication.
Compliance: 2022 Oncology Coding Update
Teri Bedard, BA, RT(R)(T), CPC

The Centers for Medicare & Medicaid Services and the American Medical Association's (AMA's) finalized coding updates for calendar year 2022.
Compliance: 2022 Physician and Freestanding Facilities Update
Teri Bedard, BA, RT(R)(T), CPC

The Medicare Physician Fee Schedule (MPFS) for calendar year 2022.