At CDF Services, we provide comprehensive medical and pharmaceutical benefits investigation. The information gathered allows rapid triaging of patients to appropriate providers ensuring timely servicing of patients' needs.
Appeals Management
If authorization is denied, CDF Services notifies and coordinates with the patient's medical provider until a final determination is reached.
Benefits Investigation
Our benefits investigations are tailored to the needs of our clients and their products. Our goal is to ensure that each investigation is appropriate for the product, channel source and potential benefit structure.
HUB Provider
CDF Services employs a single point of contact approach, which provides end-to-end services and incorporates a clearinghouse model, triaging to specialty pharmacies, clinical, and reimbursement programs.
Prior Authorization Assistance
When a prior authorization is required, CDF Services initiates the process by contacting the patient's medical provider and facilitates the collection of all necessary information to complete and retrieve reauthorization. In addition, CDF Services will assist the patient during any appeals process.
Test Claims
Our team of experienced reimbursement specialists performs test claims to quickly assess a co-pay amount as well as determine the most effective path to patient coverage. Upon completion of a test claim, our specialists will determine if a patient has coverage. CDF Services will identify necessary quantity limit overrides and prior authorization needs for claim submission.
Triage
Our HUB team will triage patients to the most appropriate provider based on the patient’s best financial outcome. The triage providers are determined by our clients and their program design which may include Specialty Pharmacies, Mail Order Pharmacies, PAP providers, Co-Pay Assistance providers and Foundations.
