Proherant provides reimbursement support services on behalf of biotechnology and pharmaceutical manufacturers. Proherant assists patients, caregivers, and healthcare professionals in navigating through the complexities of managed care systems to establish coverage for prescribed therapies. Our experienced team consists of registered nurses, insurance specialists, and customer service representatives.

Benefits investigation services
Investigation of covered benefits includes:

• Benefit verification
• Patient co-payment requirements
• Annual benefit maximums
• Lifetime benefit maximums
• Product-specific coverage criteria
• Communication of insurance benefits to patients and healthcare professionals
• Assistance with prior authorizations
• Referral status updates
• Guidance and education on denials and appeals
• Identification and research of alternative coverage options

Benefits optimization
Identification of the most cost-effective benefit option for the patient includes:

• Investigation of covered benefits
• Explanation to the patient of all benefit options, including any associated financial responsibility
• Assistance in locating a site of service which accepts benefit option

Centralized referral management
Single point of referral (SPOR) includes:

• Single point of contact and data management for all product referrals
• Experienced senior clearance specialists and reimbursement specialists
• Assistance to patients, caregivers, and healthcare professionals in establishing coverage
• Triage of referrals to appropriate specialty pharmacy providers to support timely access to the product
• Aggregated HIPAA-compliant data collection reporting to the manufacturer