Pharma in the field: Heather's story
By Xcenda
Each day as a FRAS is different, but Heather's goal is always the same: to make sure nothing stops patients from getting the care they need.
Before joining Xcenda last December, Heather spent six years managing the billing department for a private rheumatology practice, where she learned the ins and outs of healthcare billing and reimbursement. Now, as a field reimbursement and access specialist (FRAS), Heather works with a wide range of medical practices to help offices understand how to address reimbursement issues so they don't get in the way of patient access to care.
Each day on the job is different, but Heather's goal remains the same: providing education to help reduce barriers to access before they arise and, if any obstacle does come up, working with the practice staff to address it as quickly as possible. Heather does this so dynamically, in part, because of her laser focus. Since starting at Xcenda, she has concentrated on helping one manufacturer client ensure that patients can access its innovative infusion therapy for migraines as seamlessly as possible. When it comes to navigating issues like reimbursement for such a highly specialized therapy, sometimes manufacturers need to bring in experts like Heather to help educate provider offices.
Heather starts each day by consulting her calendar, which is usually filled to the brim with team meetings as well as one-on-one appointments with partners and provider accounts. She makes sure to establish relationships with the heads of billing departments in different medical offices so that if a problem arises, she can quickly find out what went wrong and help them understand how to fix it.
Depending on the issue, it might be able to get resolved quickly, or it might require research. “It might require me to reach out to another team member that's handling payer issues," Heather explains.
Whatever the problem is, Heather says, the goal is always to bring support and solutions, and help the offices understand how to address the challenge at hand.
That means communication is key. “If I'm not communicating effectively, then I might not be meeting a need for an account," Heather says. “If I'm not following up with my colleagues to address an issue, I might miss something important."
Heather says she knows from personal experience how busy the staff in a medical practice can get. “So when they do give you their time and attention, you need to be ready and you need to be organized," she says.
Heather stays organized with a cloud-based system she and her team use to log and keep track of their interactions with the offices as well as any new information about each medical practice they work with, ranging from the best points of contact to the office's preferred times and methods of interaction.
Heather also stays in communication with the manufacturer client's sales reps in order to make sure there's a collaborative game plan to address the needs of the practices they support. Her role is to focus on the reimbursement and access needs of the offices, while the sales reps are responsible for the clinical education and support of the prescriber. “There's a lot of behind-the-scenes collaboration that happens daily," Heather says.
Reimbursement isn't the only issue that comes up with regard to patient access. In the case of the drug therapy Heather supports, patient demand is high. But determining which specialty pharmacy to procure the product from can be challenging at times due to the requirements of individual patients' insurance plans.
And when it comes to advocating for changes that will ensure patients can get the care they need, Heather isn't afraid to speak up. When the manufacturer was developing its copay assistance program for patients with commercial insurance, Heather realized that there was a technical issue preventing infusion centers that provided the therapy from participating in the program. She knew that patients are far less likely to access a copay assistance program if they have to submit the paperwork themselves instead of having a provider doing it on their behalf.
Heather urged her team leads to work with the manufacturer to adjust the program to include infusion centers. “And they listened," Heather says. “I was so proud of that moment because it has a huge impact."
As a FRAS, Heather's days can sometimes be long and challenging. But they can be rewarding, too.
“At the end of the day," she says, “it's about the patient being able to get treatment and that's my driving force."
Each day on the job is different, but Heather's goal remains the same: providing education to help reduce barriers to access before they arise and, if any obstacle does come up, working with the practice staff to address it as quickly as possible. Heather does this so dynamically, in part, because of her laser focus. Since starting at Xcenda, she has concentrated on helping one manufacturer client ensure that patients can access its innovative infusion therapy for migraines as seamlessly as possible. When it comes to navigating issues like reimbursement for such a highly specialized therapy, sometimes manufacturers need to bring in experts like Heather to help educate provider offices.
Heather starts each day by consulting her calendar, which is usually filled to the brim with team meetings as well as one-on-one appointments with partners and provider accounts. She makes sure to establish relationships with the heads of billing departments in different medical offices so that if a problem arises, she can quickly find out what went wrong and help them understand how to fix it.
Depending on the issue, it might be able to get resolved quickly, or it might require research. “It might require me to reach out to another team member that's handling payer issues," Heather explains.
Whatever the problem is, Heather says, the goal is always to bring support and solutions, and help the offices understand how to address the challenge at hand.
That means communication is key. “If I'm not communicating effectively, then I might not be meeting a need for an account," Heather says. “If I'm not following up with my colleagues to address an issue, I might miss something important."
Heather says she knows from personal experience how busy the staff in a medical practice can get. “So when they do give you their time and attention, you need to be ready and you need to be organized," she says.
Heather stays organized with a cloud-based system she and her team use to log and keep track of their interactions with the offices as well as any new information about each medical practice they work with, ranging from the best points of contact to the office's preferred times and methods of interaction.
Heather also stays in communication with the manufacturer client's sales reps in order to make sure there's a collaborative game plan to address the needs of the practices they support. Her role is to focus on the reimbursement and access needs of the offices, while the sales reps are responsible for the clinical education and support of the prescriber. “There's a lot of behind-the-scenes collaboration that happens daily," Heather says.
Reimbursement isn't the only issue that comes up with regard to patient access. In the case of the drug therapy Heather supports, patient demand is high. But determining which specialty pharmacy to procure the product from can be challenging at times due to the requirements of individual patients' insurance plans.
And when it comes to advocating for changes that will ensure patients can get the care they need, Heather isn't afraid to speak up. When the manufacturer was developing its copay assistance program for patients with commercial insurance, Heather realized that there was a technical issue preventing infusion centers that provided the therapy from participating in the program. She knew that patients are far less likely to access a copay assistance program if they have to submit the paperwork themselves instead of having a provider doing it on their behalf.
Heather urged her team leads to work with the manufacturer to adjust the program to include infusion centers. “And they listened," Heather says. “I was so proud of that moment because it has a huge impact."
As a FRAS, Heather's days can sometimes be long and challenging. But they can be rewarding, too.
“At the end of the day," she says, “it's about the patient being able to get treatment and that's my driving force."
