WHAT WE DO
JDL Access Insights: Expert Guidance for In-House Patient Access Success
Our boutique patient access services company has decades of experience establishing and managing case management teams, scaling services, developing data management platforms, and ensuring efficient operations. We're committed to sharing this expertise to help you build successful in-house programs, whether you choose to work with us or develop your own team. Our team provides on-demand expertise for program optimization, scalable staffing solutions, strategic guidance for build vs. buy decisions, and comprehensive end-to-end support for launching or scaling your internal patient access program.
Patient Access Programs
Our Patient Access to Timely Healthcare (PATH) programs can manage the full spectrum of the authorization and appeals process, including benefit verification, prior authorization (predetermination, precertification), payer appeals, and external appeals for denied services (whether prior authorization or claims). We carry out these services on behalf of the patient, as they are entitled by law to an external appeal when a prior authorization or claim is denied— a common occurrence with innovative technologies. External appeals, which require payers to send cases to Independent Review Organizations (IROs), are especially effective in driving positive coverage, as the IRO reviews are costly to the payers.
Market Access Services
Our payer field team collaborates closely with our PATH service to advocate for favorable medical policies related to medical technologies. By leveraging appeals, published data, input from key opinion leaders, medical society guidelines, and other resources, the team engages and educates payers. A key component of this service includes tracking policy progress and providing real-time updates to companies on upcoming policy review dates, key resources needed to shift medical policies, and changes in policies.
Reimbursement Support Lines
When a provider or facility has general questions regarding coding, payment, or coverage for a new technology or procedure, having a dedicated hotline for education and guidance can be invaluable. Our support line is staffed with certified professional coders who are trained to assist with these inquiries.