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With the most comprehensive information on Patient Assistance Programs, Specialty Pharmacies and Clinics, and Medication Reimbursement in Canada, OkRx is on a mission to facilitate medication access and coverage information between Patients, Healthcare Providers and their teams.
Helping patients is how prescribers and healthcare professionals want to spend their time. Prescribing a specialty medication is the beginning of a complex process that takes time away from direct patient care for all healthcare professionals involved.
Once a specialty medication is prescribed, the healthcare team needs to decide if they should enroll the patient into a Patient Assistance Program. This decision is often made based on the medication’s reimbursement profile and the services the Program provides. To enroll a patient into a Patient Assistance Program the healthcare provider needs to find the proper form, obtain the patient’s signature or verbal consent and fax the form to the Program.
Some private insurers and Patient Assistance Programs require that patients apply for provincial funding before they will provide funding or assistance. If a patient is not enrolled into a Provincial Funding Program they will often need assistance with obtaining and completing the appropriate forms.
The healthcare team then needs to evaluate if a Prior Authorization form is required, if a form is required, they need to decide which one to use or wait for the Patient Assistance Program to provide one. Completing the Prior Authorization form often requires data from the patient’s medical records, from the dispensing pharmacy and information that usually comes from the patient or the patient’s guardian (i.e. information about the plan holder, enrolment in patient program, etc.). The form often requires signatures from the prescriber and the patient or the plan holder before it can be sent to the insurer.