Resources Introduction
Managing a practice is not always easy. Practices need payer information and billing forms. These are some of the tools that you will find in this section. Whether you have an established practice or you've just hung out your shingle, this information will help you and your staff.
Overview of the payer Exception Process and Other Coverage Issues
This quick reference guide will help you to learn how to request coverage under a plan's "exception process" (i.e., how to request coverage of a desired medicine when it is not on formulary or otherwise available). When a new drug becomes available, health plans may not always put the drug on their list of covered drugs immediately, and that may prevent you from obtaining new medicines. This guide will also help you with the the appeals process if your request for coverage is denied after your prescription is filled, and it has information regarding Medicare Part D, useful resources, and a planning checklist.
The Medicare Low-Income Subsidy — "Extra Help" with Prescription Drug Costs
This guide will help you understand how the Medicare Part D low-income subsidy (LIS) program may be able to help some patients afford the out-of-pocket costs usually associated with Medicare Part D prescription drug plans. The Medicare LIS program is designed to help people with low incomes and minimal resources gain by decreasing or eliminating costs such as deductibles, co-pays, and premiums associated with drugs provided under their Part D benefits. This guide reviews the basic provisions of the LIS program and eligibility criteria, compares the standard prescription drug plan benefit with LIS benefits, and provides access to tools and resources for healthcare providers and patients.
ePrescribing Selection Considerations Checklist
When evaluating an ePrescribing system, there are many elements to consider including cost, amount of effort and time to implement, and impact on practice work flow and productivity both initially and over time. This guide can be used to assist in selecting a system that best fits the needs of your practice.
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Last Modified Date: 03/10/2010