FAQ: Healthcare Professionals

Are you available 24/7?
We are not on call 24/7 (at this time) but can be available as needed on a case-by-case basis

Do you charge a fee?
Yes, we charge an hourly fee for our services. We also work on a retainer basis for particular clients/cases.

What’s the cost for me (the provider)?
It depends. When you refer a patient, the patient will pay for our services. Sometimes, family members, organizations and friends pay for our services. If you directly contract with us to help with clinical issues (training, consultations, or other professional services for your practice such as coordination of benefits, appealing denied claims, overcoming prescription restrictions, etc.) you will pay for our services.

How would you work with the case manager I have in the office now?
We work closely with your case managers, patient navigators, social workers, and all other staff to coordinate next steps, identify resources and ensure patient needs are met.

FAQ Pharmacies

Can you help my patients who are new to Medicare ?
Yes. We work with new to Medicare clients all year. Unlike agents we do not sell or receive commission from insurance companies or financial products. You can expect unbiased help.

Can you save me time at the pharmacy?
We work with clients to find the best prescription coverage for all medications by avoiding or addressing restrictions. We aren’t restricted to just a few Medicare Part D options.

Can you help patients in the Medicare Part D prescription coverage gap?
Though patient assistance programs and foundations will often help, they may have restrictions if the patient has insurance coverage. We can look for other options.

How can you help a patient who has trouble affording their medications?
We find ways to help not only with Medicare clients but others with coverage outside Medicare by exploring options for additional assistance.

Can you address insurance restriction problems, work with their prescriber, and overcome access barriers to get important medications?
We investigate what is causing the problem and figure out how to fix it. We work with the physician, pharmacy and patient by discussing the options to obtain coverage or overcome restrictions.

Are medications covered when my patient is in the hospital?
Patients admitted as outpatients or under observation are only covered under Medicare Part B, which means outpatient medications are not covered. Hospital pharmacies do not contract with Medicare Part D plans. Under these circumstances medication bills need to be submitted to the patient’s Medicare Part D plan for reimbursement.

Do you charge a fee for your services ?
Yes. We bill at an hourly rate. However, we usually can find our fee in the savings we provide our clients.

Click the links below for other FAQs

General FAQ

What is a Patient Advocate?

What is an Insurance Consultant?

FAQ: New to Medicare

FAQ: Patients and Family

FAQ: Businesses

FAQ: Prescription Drug Assistance

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