Nufactor Service Model
Our admission process includes the following services:
- Insurance Investigation: Our admission specialists investigate and verify insurance benefits and will obtain prior authorization for services. Benefit status including expected financial out of pocket responsibility is communicated. Investigation into possible copay assistance or foundation programs is also conducted to help reduce financial burden.
- Pharmacist Assessment: Our admissions pharmacists review clinical information submitted by the prescriber in order to ensure medications ordered are appropriate and dosed correctly. The pharmacist conducts a thorough interview with each patient to obtain baseline status and to ensure we are aware of all additional conditions and medications which may impact patient care. The admissions pharmacist provides education and counseling on a patient specific basis including disease state information, expected response to therapy, medication information such as side effects and their management, storage, how to call for refills, drug utilization review and other pertinent items. Nufactor will provide medication, equipment and supplies as necessary for therapy. Nufactor utilizes Surescripts as it's e-prescribing platform which integrates directly with the pharmacy system.
- Nursing: Our in house nursing staff coordinates care with contracted and credentialed agencies local to the patient and provide tips on home safety and safe infusion practices.
- Client Support Specialist (CSS): Each patient is assigned a CSS who will become their single point of contact throughout the duration of therapy with Nufactor. The CSS manages communication including proactive contact to schedule refills of medications and supplies, obtain updates including insurance changes, and specific information on how therapy is proceeding. The CSS acts as the liaison between the patient and the clinical team. All clinical needs or concerns are immediately escalated to the pharmacist for resolution. Insurance or pertinent life changes are communicated to the appropriate internal staff to address.
- Pharmacy Team: Each patient is assigned to a pharmacy team for ongoing management. The pharmacist assesses clinical status including side effects and mitigation strategies, response to therapy, and tracking of labs when applicable. Pharmacy technicians ensure active prescriptions are on file and assist in the refill process.
- Authorization Coordinators: Reverify benefits and eligibility monthly and proactively track and submit for reauthorization to avoid breaks in therapy.
- Reimbursement: Submit claims to insurance providers and track for payment and resolve any payment discrepancies
- PATIENT MANAGEMENT PROGRAM: Patients are automatically included in our Patient Management Program, a collaborative process that assesses, plans, implements, coordinates, monitors, and/or evaluates options to meet patients' health needs through communication and available resources to promote quality, cost-effective outcomes.
- REQUESTS FOR MEDICATION/SUPPLY REFILLS: HOME DELIVERY: As a part of our home services, supplies and medications are delivered direct to the patient's home. All deliveries are tracked to ensure arrival.
- PATIENT ASSISTANCE PROGRAM: Nufactor assists in finding solutions for those having difficulty managing out-of-pocket expenses related to therapy. These may include manufacturer copay assistance programs or Foundation programs.
- APPEALS MANAGEMENT: Nufactor assists in managing denials of therapy through the entire appeals process including writing appeal letters for prescribers to review, edit and approve, and tracking the status of appeals until final resolution.
The information provided on this website is not medical advice, nor is it intended to be a substitute for medical advice, diagnosis, and treatment. Always seek the advice of a physician or other qualified health provider with questions concerning a medical condition. Never disregard professional medical advice, or delay seeking it based on information provided on this website.