Patient Enrollment/Claim Review
Successfully paving a smooth patient journey is something we take pride with at RIS Rx. A precursor to affordability and access programs, RIS Rx offers a fully scalable model for onboarding patients into manufacturer sponsored patient support programs. Maintaining and ensuring ongoing program compliance is an important hallmark to program integrity and the critical downstream success of patient support programs.
Our process encourages active insurance procurement via real-time benefits verification (RTBV) and electronic benefits investigation (eBI) via our flagship benefits transparency tool, PreVail.
PreVail – Electronic Benefit Investigation (eBI)
Bring pricing transparency to patients and healthcare professionals with our latest solution, PreVail.
PreVail is our flagship electronic benefits investigation (eBI) tool that delivers price transparency in real-time to all stakeholders in the healthcare continuum. PreVail delivers results in real-time and can deliver insights from all PBMs and payers.
PreVail brings benefits transparency into the hands of patients, caregivers and HCPs by offering a direct pathway to view prospective co-pays, deductibles and coverage restrictions.
Complex disease states require advanced solutions to ensure that patients are effectively screened, and coverage is procured and secured. A standard Specialty BI or FullBI can help to ensure that patients are appropriately screened to ensure continuity of care.
As one of RIS Rx’s core capabilities, Specialty BI involves a methodical and multi-touchpoint process to ensure all stakeholders have accountability for reimbursement.
Medical Benefits Investigation
Not all specialty drugs are created equal. The specialty landscape is in constant reform, represented by perpetually changing benefit structure types.
By and large, most specialty drugs are covered through prescription benefits. However, there has been a recent shift to a including a stronger emphasis on the Buy & Bill model.
RIS Rx provides industry leading Buy & Bill and Medical Benefits Investigation (MedBI) results to ensure patient support models are comprehensive and cohesive, regardless of benefit structure, so that no patient is left unaccounted.
As part of our core services offerings, our expertise in MedBI can result in quicker turn-around times, decreased patient and HCP input and an overall smoother patient support process.
Prior Authorization Management & Support
Prior authorizations have become a normal staple as part of the prescription procurement process. Prior Authorizations can often be a challenging task for many HCPs to incorporate as part of their day-to-day. Partnering with a reliable supporting solutions vendor is a key component to ensuring success during this critical process of the patient journey.
Call Center Support
RISRx is pleased to deliver premium stand alone — or integrated — call center services to arm your brand with the signature RIS Rx support hallmarks.
Our industry recognized call center is equipped with the latest in virtual call center technology that promotes a near 99.8% uptime — so your services never go interrupted.
Our call center solutions offer the following;
- Remote support and handling of customer/client inquiries
- Robust data analytics to measure KPIs
- HIPAA/HITECH entrusted
- Pharmacovigilance equipped
- Adverse event reporting
Commercial Loyalty Program Management
Known for our tradition of quality and expertise from our role in therapeutics, RIS Rx is proud to deliver the same level of service for commercial loyalty program management.
We offer complete oversight and administration of commercial loyalty program management which includes call center, payment/rewards disbursement, rewards tracking, website overhaul and stakeholder communication.
- Best-in-Class call center support & analytics
- Co-op Program Management
- Integration with CRM platforms
- Full payment support for clients
- ACH Payment
- Debit Card
- Front-end and back-end web design and support
AlertRx – Co-Pay Maximizer & Accumulator Adjustment Management
RIS Rx is pleased to offer AlertRx, a variable co-pay program mitigation strategy tool to protect your patients from the potential risk of Co-pay Maximizer & Accumulator Adjustment Programs.
Starting first with a professional consultation and high-level analysis, RIS Rx will measure the potential impact of the variable co-pay program and issue a series of process recommendations and enhancements.
Ongoing management and transparency are key to ensure a successful downstream effect. RIS Rx will equip your brand with the insight, analytics and industry acumen to protect your most at risk patients.