Pharma - HUB Services

P5 Connect offers a comprehensive portfolio of services designed to assist our partners from physician referral to product delivery while maintaining the best adherence and therapy completion rates. All services are managed through the P5 Connect HUB which provides a branded consistent patient and physician service model irrespective of where the medication is delivered from.

Referral Managemt

Referral Management
P5 Connect will work with the Pharmaceutical Company to produce a Referral form that captures the information necessary to get patients started on therapy quickly as well as capturing the information to manage benefits verification and prior authorization process. Referrals are submitted to a P5 Connect dedicated team member to initiate the start of therapy process. Referrals are reviewed immediately to ensure completeness and an acknowledgement of receipt is sent back to the physician. If any information is missing a call is made to the physician’s office to obtain the missing data elements.

Reimbursement Support

Benefits Verification
. Our benefits verification team is expert in handling all aspects of insurance coverage and will complete the process for physician, pharmacy, and patient. All outcomes from the benefit verification process are then communicated to the physician and patient to determine product delivery model that is best suited for each patient. In the event the patient needs additional assistance where coverage is limited, one of our experienced team members will assist the patient in selecting the appropriate patient assistance program.
Prior Authorization
We don’t just assist with the Prior Authorization, we manage it. P5 Connect will ensure and follow the prior authorization process from start to finish and proactively manage the renewal process to ensure there are no interruptions in patient therapy. A full database of coverage and criteria for each medication for each insurance is maintained to effectively collect the pertinent information from the physician that will result in higher approvals and quicker turnaround time.
Appeals Management
We support physicians and pharmacies in all appeals. These appeals can occur for either billing issues or prior authorizations. All correspondence with the insurance companies and Prior Authorization process are documented within the HUB to assist in the appeal process.
Payer Benefit
All payer benefit coverage criteria for the medication and therapy is documented in the P5 Connect HUB system. This information is utilized to obtain all necessary data elements prior to requesting benefit coverage resulting in quicker approval time frames for coverage and prior authorizations. We also share the coverage criteria and partner with the Pharmaceutical Medical Affairs division to improve overall benefit coverage for their products.
Billing & Coding Support
We support the billing process for both the physicians and dispensing pharmacies. Our proprietary “How To Bill Document” is sent to the physician’s office for every administration and contains all the necessary information to assist the physician in the creation of the billing invoice.

Become a Partner

Contact P5 Connect Today. 818.377.7406