MolecularHealth Provides Unprecedented Reimbursement Support with RxAssistance
New offering helps doctors and patients navigate reimbursement for TreatmentMAP-recommended therapies
THE WOODLANDS, Texas--(BUSINESS WIRE)--MolecularHealth announced today an important new component of its TreatmentMAP™ offering in the United States, called MolecularHealth™ RxAssistance. This new service is a value-added benefit for patients and their doctors, providing a level of reimbursement support not previously seen in the molecular diagnostic industry. Unlike reimbursement services offered by other companies that only assess insurance options for the molecular diagnostic test itself, RxAssistance evaluates insurance options for the therapies recommended by its tests.
“From a physician’s perspective, getting this information is a major time saver and will help them deliver treatment to their patients at a faster pace. Our internal expertise in physician treatment and reimbursement options for oncology gave us a significant head start in supporting our customers in this effort.”
RxAssistance is designed to help streamline the reimbursement process and provide physicians and patients with support and education about payer reimbursement for treatment options. Each patient’s TreatmentMAP results report and insurance information is reviewed by MolecularHealth’s reimbursement specialist, a Certified Professional Coder®, prior to results being sent to the physician. Off-label or investigational products recommended for treatment are flagged and information is gathered, including the likelihood a payer will reimburse for the suggested treatments and any additional information that will be needed to receive reimbursement, such as a letter of medical necessity.
“We saw an unmet customer need, specifically that it has been left to the physician’s office to determine whether or not treatments would be paid for on behalf of patients. The problem is, a typical oncologist might see a dozen patients in a day, so their offices simply don’t have the capacity to handle this time-intensive process,” said Laura Housman, senior vice president and chief commercial officer at MolecularHealth. “From a physician’s perspective, getting this information is a major time saver and will help them deliver treatment to their patients at a faster pace. Our internal expertise in physician treatment and reimbursement options for oncology gave us a significant head start in supporting our customers in this effort.”
RxAssistance has been integrated into TreatmentMAP’s end-to-end offering and is currently included as a value-added component of all orders. When a physician receives a patient’s results report, they also receive an accompanying RxAssistance report, providing information on pre-authorization, patient responsibility for co-pays and deductibles, letters of medical necessity, and step therapy requirements and/or medical benefit formularies.
Housman continued, “There is a burdensome psychological up and down a patient experiences when they learn of a hopeful treatment, but are unsure if it will be reimbursed by their insurer. Our goal is to clear that hurdle quickly by tying this information to our results report. If we can accomplish that, then we feel RxAssistance is not only a great service to physicians, but also for patients who can then know their immediate treatment path right away.”
MolecularHealth is a leading biomedical company that is transforming molecular data into clinically actionable information to inform the most efficient and safest cancer treatment options for each individual cancer patient.
In the U.S., TreatmentMAPTM is a laboratory developed test (LDT) performed at MolecularHealth’s CLIA-certified laboratory. In Europe, TreatmentMAP is the first registered medical device of its kind for personalized cancer medicine and offered through a network of certified physicians. MolecularHealth GmbH is certified according to DIN EN ISO 13485.
MolecularHealth, comprised of a multidisciplinary team of oncologists, scientists, businesspeople, and IT experts with long-standing expertise in their fields, works in partnership with some of the world’s leading healthcare, information technology and NGS companies, including the U.S. Food and Drug Administration (FDA), University of Texas MD Anderson Cancer Center, SAP AG and GATC Biotech.
Located in the centers of cancer research in Europe and U.S., the company is headquartered in Heidelberg, Germany, and its U.S. headquarters, including a CLIA-certified NGS lab, is located in The Woodlands, Texas. The company also has offices in Boston, Mass.