Why is educating payers important in helping patients get access to products?
Payers face many challenges in the approval of pharmaceuticals and medical devices. We educate payers about the clinical effectiveness and benefits of our clients’ products in order to optimize the potential for claim payment. HealthBridge also educates payers about new indications or off-label use that is supported by clinical studies. This can result in changes to payer policy favorable to patients. It is not unusual for recently approved indications of a therapy to nevertheless trigger a denial usually because the payer has not yet received the criteria to evaluate medical necessity. In these cases, HealthBridge identifies senior decision-makers at the payer organization, and educates them by providing medical literature and information on the new indication. The payer then establishes criteria for the new indication, paving the way for patients to benefit from the therapy.
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