The Cystic Fibrosis Foundation provides funding and accreditation for more than 130 care centers nationwide. Care centers provide highly specialized care that people with CF need to lead longer, healthier lives. Oftentimes, care team members are the first to receive questions about insurance and local resources because of the nature of their relationship with patients and families. CF Foundation Compass can be a partner in tackling these questions so care team members can spend more meaningful time with their patients and their families.
Insurance
Often calls to insurance companies take hours spent on hold and frustrating transfers between departments, just to get simple information. With permission from your patient (or your patient's guardian), Compass can help by calling the insurance plan to:
- Verify a patient's drug, service, and network benefits
- Find out prior authorization criteria for your patient's prescriptions
- Research the appeals process for denied drug coverage
When navigating complex insurance issues, it is important to take a couple of steps when engaging insurance companies:
- Connect with the correct department when calling the payer to get answers to coverage decisions, like asking to speak with the prior authorization team to find out about prior authorization criteria, or the claims department to dispute a claim or find out about the appeal process.
- Keep good and thorough documentation on with whom you spoke and ask for a reference number.
- Prepare a complete packet of supporting documentation to demonstrate medical necessity.
Working With You
Compass is here to help you help your patients. Together, you and Compass can tag team to solve coverage and reimbursement issues, look into benefits, and explore financial assistance programs to benefit your patients by saving on medications, services, and other living expenses. Some ways Compass can work with you include:
- Direct calls to help troubleshoot questions without a patient referral
- Joint conference calls with you and your patient
- Calls with patients whom you referred
- Conducting research to identify national or local resources to assist patients with issues that could affect their care, such as food insecurity, accommodations, and living expenses
Compass now has a new, streamlined consent and authorization process, making the process of referring patients to Compass easier.
Provider Education
In 2018, Compass introduced a new resource, “Medicare for People With Cystic Fibrosis: A Guide for Care Teams.” The guide helps care teams understand Medicare and its intricacies and is meant to support conversations with patients about the program and its benefits. Email compass@cff.org for a copy.
Compass will continue to roll out educational resources for care teams, including webinars that delve into insurance topics that may be at the forefront of your patients' minds.
Patient Education
Do your patients want tools to help guide them through challenges related to life with cystic fibrosis? Navigating CF is a new, interactive series that helps people with cystic fibrosis, their families, and care teams navigate complex situations related to life with CF. Compass case managers share their knowledge and expertise in a short series of guided, interactive videos intended to help users better understand insurance, financial, legal, and other topics related to life with CF. The series is available on demand on CFF.org.
Connect With Compass
Compass is always interested to hear from you and your care team colleagues on how we can better work with you now and in the future. Our goal is to continue being a partner so you can devote more meaningful time with your patients.
You and your patients should always feel free to call Compass at 844-COMPASS (844-266-7277) Monday through Friday, 9 a.m. until 7 p.m. ET, or email us at compass@cff.org.