Subscribe
IQVIA Blog Digest
For all the latest industry insights, please subscribe to the IQVIA U.S. blog digest.
-
Americas
-
Asia & Oceania
-
A-I
J-Z
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more -
Middle East & Africa
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more
Regions
-
Americas
-
Asia & Oceania
-
Europe
-
Middle East & Africa
-
Americas
-
Asia & Oceania
-
Europe
Europe
- Adriatic
- Belgium
- Bulgaria
- Czech Republic
- Deutschland
- España
- France
- Greece
- Hungary
- Ireland
- Israel
- Italia
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more -
Middle East & Africa
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more
WHO WE HELP
-
Pharmaceutical Manufacturers
-
Emerging Biopharma
-
MedTech
-
Financial Institutions
-
Government and Public Health
-
Health Plans
-
Hospital and Health Systems
-
Insurers and Risk
-
Medical Specialty and Patient Advocacy
Pharmaceutical Manufacturers
Harness unparalleled healthcare data, advanced analytics, and cutting-edge technologies with our expertise to accelerate the development and commercialization of innovative medicines, enhancing patient lives.
Discover MorePharmaceutical Manufacturers
Emerging Biopharma (Global page)
Boost your innovation with IQVIA's expert team. Our comprehensive solutions integrate top-tier insights, technology, and expertise to maximize your asset's success in a competitive landscape.
Discover InnovationsMedTech
Navigating MedTech's unique landscape: U.S. decision-making now rests with GPOs, IDNs, and payers, who demand solid value proof through rigorous outcomes analyses and pricing scrutiny.
Explore MedTechMedTech
Financial Institutions
Invest in healthcare with confidence. Stay ahead of pharma and medical device trends using real-time, high-quality data. Access market insights, historical sales, prescription trends, and emerging product information for informed, risk-reduced decisions.
Access InsightsGovernment and Public Health
Unlock deeper health insights with unmatched data and innovative technology to enhance decision-making for your essential government programs.
Unlock InnovationsGovernment and Public Health
Health Plans
Accelerate digital innovation with our data-driven expertise in data science and healthcare, optimizing business processes for smarter decisions.
Navigate Health PlansHospital and Health Systems
Leverage digital innovation to cut costs, boost efficiency, and elevate patient engagement, all while enhancing quality and health outcomes.
Streamline DecisionsHospital and Health Systems
Insurers and Risk
Enhance your ability to evaluate and forecast population risk swiftly and accurately by integrating unmatched data, expertise, and technology.
Uncover More
Medical Specialty and Patient Advocacy
Transform into a data-driven organization that enhances your specialty and showcases value to your members through digital transformation.
Explore NowU.S. PROGRESS POINT
A curation of IQVIA's best thinking on topics and trends driving change, disruption, and progress in the United States healthcare market.
LEARN MOREBLOGS, WHITE PAPERS & CASE STUDIES
Explore our library of insights, thought leadership, and the latest topics & trends in healthcare.
DISCOVER INSIGHTS
PODCASTS
"Discover the future through our enlightening podcasts available in the United States.
EXPLORE PODCASTSBlog
Field Reimbursement Managers Are Your Frontline
Sep 13, 2021
Often, the “last mile” of the circuitous access and reimbursement journey is the most challenging to navigate, especially when it comes to expensive specialty therapies. Long after the evidence has been presented, the price negotiated, and the contract signed, providers and patients still need to be reimbursed by payers for the treatment. This final step is just as critical to a product’s success as earlier dealings with payer organizations as two out of three patients are unable to navigate controls.1 The answer to addressing these challenges is leveraging the support of a specialist: The field reimbursement manager (FRM).
The work of FRMs, which includes facilitating product fulfillment, addressing claim denials, coordinating appeals processes, and verifying the information on intake forms, is now harder – but more necessary – than ever. Payers continue to tighten their controls with the use of step-edits and labyrinthine prior authorization requirements. Meanwhile, high unemployment rates and the loss of, or changes in, health insurance coverage exacerbated by the COVID-19 pandemic, have made it difficult for many patients to afford their medications.
The reimbursement frontline
FRMs work every day on the frontlines assisting providers in resolving reimbursement challenges that can be barriers to patients receiving the full benefits of their treatment plan. FRMs act as liaisons between providers, patients, payers, field sales, and the patient hub. Their intervention and expertise allow providers to spend more time providing quality patient care throughout the product lifecycle. This is particularly important during the launch period when proactive education can ensure the accuracy and completeness of intake forms and reimbursement information.
In time, assuming that payer policies and the competitive landscape are stable, this work moves to supporting office staff and practice managers remotely.
The impact of the COVID-19 pandemic
Providing proactive education and one-on-one support has been particularly challenging during the COVID-19 pandemic. Healthcare providers (HCPs) and office staff have been overwhelmed with the need to enact guidelines and practice safety protocols all while attempting to resume normal patient loads. These factors have added administrative time and burdens to overwhelmed offices who were already spending less time with patients.
COVID-19 has only solidified the need for FRMs to be advocates for providers and patients as they struggle along the reimbursement journey. FRMs help patients gain access to medically necessary treatments sooner and communicate with other stakeholders to secure financial assistance.
Support for support staff
FRMs perform their services best when they have the right information and tools at their disposal. By using a suite of data sources and applying dynamic insight generation, teams can segment HCPs based on personalized education and support needs. This requires teams to be armed with real-time policy information, secondary medical and prescription claims information, and appropriate HUB and patient support program data to enable proactive communication that meets provider-specific needs. Only then can they create and deliver effective education materials to support providers and patients.
1 IQVIA Launch Analyzer for Market Access, 2013-2020
Enable continuous access to treatment
Read more about Dynamic Deployment for Access and Reimbursement.