Proactive Interventions for the Prior Authorization Process

How to Prepare for the Prior Authorization Blizzard

In the first webinar, we heard from Sarah Hudson-DiSalle, PharmD, Rph, Pharmacy Manager, from The James Cancer Hospital, and Jordan Karwedsky, Financial Counselor from Green Bay Oncology. In this webinar, we discussed ACCC Prior Authorization Focus Group findings, payer recommendations, and how to best prepare for the prior authorization "blizzard" for next year.

How to Make the Pharmacy Your Prior Authorization Ally

In the second webinar, we heard from Andre D. Harvin, PharmD, MS, Executive Director of Pharmacy for Oncology at Cone Health. We discussed how your pharmacy team can be a major ally and support in obtaining prior authorizations, help navigate biosimilar changes, and address medical necessity.

Addressing the High Cost of Radiology Services

In the third webinar, we heard from Jennifer Paquet, RN, BSN, Financial Assistance Patient Care Coordinator Supervisor from Bassett Cancer Institute and Aimee Hoch, MSW, LSW, Oncology Financial Navigator from Grand View Health Cancer Center. We discussed barriers to radiology prior authorizations and provide insights on how to address them.

Navigating Radiation Authorizations and Denials

In the fourth webinar, we heard from Gretchen Van Dyck, Financial Counselor from St. Vincent Hospital Regional Cancer Center and Rachelle Gill, Program/Department Coordinator II for Proton Therapy Appeals at Fred Hutchinson Cancer Center. Listen in on the discussion around radiation authorization submissions before treatment and strategies on how to work radiation authorization denials and appeals after treatment.

Putting “Necessity” in Medical Necessity: How to Ensure You Are Maximizing Reimbursement

In the fifth webinar, we heard from Angie Santiago, CRCS, Manager of Oncology Financial Advocacy, Sidney Kimmel Cancer Center at the Thomas Jefferson University Health System, and Chair of ACCC’s Financial Advocacy Network, and Sarah Shaw, Oncology Program Manager at St. Luke’s Cancer Institute in Boise, ID. Our panelists discussed the importance of medical necessity in oncology and how clear denial data can help maximize reimbursement.

Utilizing Biomarkers in Cancer Care: Who has it, Who needs it, and How to access it

In the final webinar, we heard from experts Jordan Karwedsky, Financial Counselor, Green Bay Oncology, Wendi Waugh, BS, RT(R)(T), CMD, CRT, Administrative Director of SOMC Cancer Services & Ambulatory Infusion, Southern Ohio Medical Center, and Dr. Michael R. Gieske, Director of Lung Cancer Screening. Listen in on the discussion around prior authorization challenges in biomarker testing, importance of providing access to biomarker testing for underserved populations, how biomarkers are shaping the future of medicine, as well as what can be done at the policy level to allow for more access.  

  • How to Prepare for the Prior Authorization Blizzard
    Contains 2 Component(s)

    The first in a 6-part series, titled, “Proactive Interventions for the Prior Authorization Process”

    You must have an ACCC account in order to register for this course/webinar/webinar series.

    If You DO NOT Have An ACCC Account:

    • To start, click the green “Register” button in the upper right corner of this page. You will be directed to “Your Cart.” Click the green “Log In” button near the top of the page.
      • ACCC members: Click “Reset Password” to update your login information. When your password is updated, you will be redirected to the “My Profile” page, where you can view and update your information.
      • OSS at ACCC Members: Please use your state society login credentials.
      • Non-members: Click “Create Account.” Once your password is created, you will be redirected to the "My Profile" page, where you can view and update your information. Click “Change” to add your Areas of Concentration, then save your information.
    • Click “eLearning” at the top of your profile page to go back to the ACCC eLearning portal. In the box on the left side of the screen, click on the “Cart” link.
    • The green box in the upper right corner of this page will indicate “You are registered!” for this course. Congratulations!

    If You Have An ACCC Account:

    • Please click the orange “Log In” button on the left side of this screen. You will be taken to the main login page that displays your email and password. Click the “Log in” button.
    • You will be automatically redirected back to this course/webinar page, and the green box in the upper right corner will say that “You are registered!” for this course. Congratulations!

    PRO TIP: If you save your ACCC password to your computer and remain logged in, you can register for additional webinars and courses in a matter of seconds—with just one click!

    For the best registration and viewing experience, please use Chrome, Edge, or Safari web browsers. Internet Explorer Users may experience difficulties accessing the webinar.

    Once you complete your registration, you will receive an email from ACCC eLearning, which contains information on how to access this course/webinar . For assistance with registration or if you do not receive an email, please contact registration@accc-cancer.org.

    In the first webinar, we heard from Sarah Hudson-DiSalle, PharmD, Rph, Pharmacy Manager, from The James Cancer Hospital, and Jordan Karwedsky, Financial Counselor from Green Bay Oncology. In this webinar, we discussed ACCC Prior Authorization Focus Group findings, payer recommendations, and how to best prepare for the prior authorization "blizzard" for next year.

  • How to Make the Pharmacy Your Prior Authorization Ally
    Contains 2 Component(s)

    The second in a 6-part series, titled, “Proactive Interventions for the Prior Authorization Process”

    You must have an ACCC account in order to register for this course/webinar/webinar series.

    If You DO NOT Have An ACCC Account:

    • To start, click the green “Register” button in the upper right corner of this page. You will be directed to “Your Cart.” Click the green “Log In” button near the top of the page.
      • ACCC members: Click “Reset Password” to update your login information. When your password is updated, you will be redirected to the “My Profile” page, where you can view and update your information.
      • OSS at ACCC Members: Please use your state society login credentials.
      • Non-members: Click “Create Account.” Once your password is created, you will be redirected to the "My Profile" page, where you can view and update your information. Click “Change” to add your Areas of Concentration, then save your information.
    • Click “eLearning” at the top of your profile page to go back to the ACCC eLearning portal. In the box on the left side of the screen, click on the “Cart” link.
    • The green box in the upper right corner of this page will indicate “You are registered!” for this course. Congratulations!

    If You Have An ACCC Account:

    • Please click the orange “Log In” button on the left side of this screen. You will be taken to the main login page that displays your email and password. Click the “Log in” button.
    • You will be automatically redirected back to this course/webinar page, and the green box in the upper right corner will say that “You are registered!” for this course. Congratulations!

    PRO TIP: If you save your ACCC password to your computer and remain logged in, you can register for additional webinars and courses in a matter of seconds—with just one click!

    For the best registration and viewing experience, please use Chrome, Edge, or Safari web browsers. Internet Explorer Users may experience difficulties accessing the webinar.

    Once you complete your registration, you will receive an email from ACCC eLearning, which contains information on how to access this course/webinar . For assistance with registration or if you do not receive an email, please contact registration@accc-cancer.org.

    In the second webinar, we heard from Andre D. Harvin, PharmD, MS, Executive Director of Pharmacy for Oncology at Cone Health. We discussed how your pharmacy team can be a major ally and support in obtaining prior authorizations, help navigate biosimilar changes, and address medical necessity.

  • Addressing the High Cost of Radiology Services
    Contains 2 Component(s)

    Sign-up for the third webinar in a 6-part series, titled, “Addressing the High Cost of Radiology Services.”

    You must have an ACCC account in order to register for this course/webinar/webinar series.

    If You DO NOT Have An ACCC Account:

    • To start, click the green “Register” button in the upper right corner of this page. You will be directed to “Your Cart.” Click the green “Log In” button near the top of the page.
      • ACCC members: Click “Reset Password” to update your login information. When your password is updated, you will be redirected to the “My Profile” page, where you can view and update your information.
      • OSS at ACCC Members: Please use your state society login credentials.
      • Non-members: Click “Create Account.” Once your password is created, you will be redirected to the "My Profile" page, where you can view and update your information. Click “Change” to add your Areas of Concentration, then save your information.
    • Click “eLearning” at the top of your profile page to go back to the ACCC eLearning portal. In the box on the left side of the screen, click on the “Cart” link.
    • The green box in the upper right corner of this page will indicate “You are registered!” for this course. Congratulations!

    If You Have An ACCC Account:

    • Please click the orange “Log In” button on the left side of this screen. You will be taken to the main login page that displays your email and password. Click the “Log in” button.
    • You will be automatically redirected back to this course/webinar page, and the green box in the upper right corner will say that “You are registered!” for this course. Congratulations!

    PRO TIP: If you save your ACCC password to your computer and remain logged in, you can register for additional webinars and courses in a matter of seconds—with just one click!

    For the best registration and viewing experience, please use Chrome, Edge, or Safari web browsers. Internet Explorer Users may experience difficulties accessing the webinar.

    Once you complete your registration, you will receive an email from ACCC eLearning, which contains information on how to access this course/webinar . For assistance with registration or if you do not receive an email, please contact registration@accc-cancer.org.

    In the third webinar, we heard from Jennifer Paquet, RN, BSN, Financial Assistance Patient Care Coordinator Supervisor from Bassett Cancer Institute and Aimee Hoch, MSW, LSW, Oncology Financial Navigator from Grand View Health Cancer Center. We discussed barriers to radiology prior authorizations and provide insights on how to address them.

    Jennifer Paquet, RN, BSN

    Bassett Cancer Institute

    Aimee Hoch, MSW, LSW

    Oncology Financial Navigator

    Grand View Health Cancer Center

    Aimee Hoch, LSW, OSW-C, is a Masters Level Social Worker with 20 plus years of experience in both healthcare and behavioral health. She earned her MSW from Fordham University Lincoln Center. A Financial Navigator for the Oncology Program at Grand View Health, Aimee is an advocate for individuals diagnosed with cancer by meeting them with empathy and connecting them with resources to support them during their most vulnerable times.

    Aimee is a consultant for the Cancer Support Community as a Financial Navigation specialist and is a member of their Biosimilar Advisory Board. She is an active member of the Association of Community Cancer Center’s (ACCC) Financial Advocacy Network Advisory Committee and Voice Task Force.  She speaks about Financial Toxicity and the role of Financial Navigation in cancer care.  Aimee has been a guest on Cancer Buzz TV, Patient Power, and WDVR. She has been featured in publications including Breastcancer.org, Patient Power, and ACCC’s Financial Advocate Spotlight. Aimee has contributed to ACCC’s Patient Assistance and Reimbursement Guide and OncoLink News. 

  • Navigating Radiation Authorizations and Denials
    Contains 1 Component(s)

    The fourth installment in a 6-part series, titled, “Proactive Interventions for the Prior Authorization Process."

    You must have an ACCC account in order to register for this course/webinar/webinar series.

    If You DO NOT Have An ACCC Account:

    • To start, click the green “Register” button in the upper right corner of this page. You will be directed to “Your Cart.” Click the green “Log In” button near the top of the page.
      • ACCC members: Click “Reset Password” to update your login information. When your password is updated, you will be redirected to the “My Profile” page, where you can view and update your information.
      • OSS at ACCC Members: Please use your state society login credentials.
      • Non-members: Click “Create Account.” Once your password is created, you will be redirected to the "My Profile" page, where you can view and update your information. Click “Change” to add your Areas of Concentration, then save your information.
    • Click “eLearning” at the top of your profile page to go back to the ACCC eLearning portal. In the box on the left side of the screen, click on the “Cart” link.
    • The green box in the upper right corner of this page will indicate “You are registered!” for this course. Congratulations!

    If You Have An ACCC Account:

    • Please click the orange “Log In” button on the left side of this screen. You will be taken to the main login page that displays your email and password. Click the “Log in” button.
    • You will be automatically redirected back to this course/webinar page, and the green box in the upper right corner will say that “You are registered!” for this course. Congratulations!

    PRO TIP: If you save your ACCC password to your computer and remain logged in, you can register for additional webinars and courses in a matter of seconds—with just one click!

    For the best registration and viewing experience, please use Chrome, Edge, or Safari web browsers. Internet Explorer Users may experience difficulties accessing the webinar.

    Once you complete your registration, you will receive an email from ACCC eLearning, which contains information on how to access this course/webinar . For assistance with registration or if you do not receive an email, please contact registration@accc-cancer.org.

    In the fourth webinar, we heard from Gretchen Van Dyck, Financial Counselor from St. Vincent Hospital Regional Cancer Center and Rachelle Gill, Program/Department Coordinator II for Proton Therapy Appeals at Fred Hutchinson Cancer Center. Listen in on the discussion around radiation authorization submissions before treatment and strategies on how to work radiation authorization denials and appeals after treatment.

  • Putting “Necessity” in Medical Necessity: How to Ensure You Are Maximizing Reimbursement
    Contains 2 Component(s)

    The fifth in a 6-part series, titled, “Proactive Interventions for the Prior Authorization Process”

    You must have an ACCC account in order to register for this course/webinar/webinar series [specify].

    If You DO NOT Have An ACCC Account:

    • To start, click the green “Register” button in the upper right corner of this page. You will be directed to “Your Cart.” Click the green “Log In” button near the top of the page.
      • ACCC members: Click “Reset Password” to update your login information. When your password is updated, you will be redirected to the “My Profile” page, where you can view and update your information.
      • OSS at ACCC Members: Please use your state society login credentials.
      • Non-members: Click “Create Account.” Once your password is created, you will be redirected to the "My Profile" page, where you can view and update your information. Click “Change” to add your Areas of Concentration, then save your information.
    • Click “eLearning” at the top of your profile page to go back to the ACCC eLearning portal. In the box on the left side of the screen, click on the “Cart” link.
    • The green box in the upper right corner of this page will indicate “You are registered!” for this course. Congratulations!

    If You Have An ACCC Account:

    • Please click the orange “Log In” button on the left side of this screen. You will be taken to the main login page that displays your email and password. Click the “Log in” button.
    • You will be automatically redirected back to this course/webinar <specify> page, and the green box in the upper right corner will say that “You are registered!” for this course. Congratulations!

    PRO TIP: If you save your ACCC password to your computer and remain logged in, you can register for additional webinars and courses in a matter of seconds—with just one click!

    For the best registration and viewing experience, please use Chrome, Edge, or Safari web browsers. Internet Explorer Users may experience difficulties accessing the webinar.

    Once you complete your registration, you will receive an email from ACCC eLearning, which contains information on how to access this course/webinar <specify>. For assistance with registration or if you do not receive an email, please contact registration@accc-cancer.org.

    In the fifth webinar, we heard from Angie Santiago, CRCS, Manager of Oncology Financial Advocacy, Sidney Kimmel Cancer Center at the Thomas Jefferson University Health System, and Chair of ACCC’s Financial Advocacy Network, and Sarah Shaw, Oncology Program Manager at St. Luke’s Cancer Institute in Boise, ID. Our panelists discussed the importance of medical necessity in oncology and how clear denial data can help maximize reimbursement.

    Angie Santiago, CRCS

    Manager, Oncology Financial Advocacy

    Sidney Kimmel Cancer Center

    Angie Santiago, CRCS-I, is the Manager for Oncology Financial Advocacy, with the Thomas Jefferson University Health System, Sidney Kimmel Cancer Center. She created and implemented the Oncology Patient Assistance Program that is utilized at the Thomas Jefferson University Health System. The program was initiated to assist patients with the acquisition of supplemental financial coverage, over and beyond what has been traditionally provided by the hospital’s business office. Angie has worked in healthcare for almost 16 years within patient access, revenue cycle and financial counseling. She has presented on financial toxicity and related topics at patient navigators networking meetings. She is a graduate of the ACCC Financial Advocacy Network Boot Camp.

    Sarah Shaw

    Oncology Program Manager

    St. Luke's Cancer Institute

    Sarah Shaw is the Oncology Program Manager at St. Luke’s Cancer Institute. She is very experienced in financial advocacy for sensitive patient populations, insurance optimization, government and low-income subsidy programs, transplant financial coordination, and data collection and analysis. Recognized for being a strong patient advocate and liaison between patients and clinicians. Strong problem solver with the ability to analyze new processes and suggest process improvements. Adept at using a variety of documentation systems including Epic. 

  • Utilizing Biomarkers in Cancer Care: Who has it, Who needs it, and How to access it
    Contains 1 Component(s)

    The final webinar in a 6-part series, titled, “Proactive Interventions for the Prior Authorization Process.”

    You must have an ACCC account in order to register for this course/webinar/webinar series [specify].

    If You DO NOT Have An ACCC Account:

    • To start, click the green “Register” button in the upper right corner of this page. You will be directed to “Your Cart.” Click the green “Log In” button near the top of the page.
      • ACCC members: Click “Reset Password” to update your login information. When your password is updated, you will be redirected to the “My Profile” page, where you can view and update your information.
      • OSS at ACCC Members: Please use your state society login credentials.
      • Non-members: Click “Create Account.” Once your password is created, you will be redirected to the "My Profile" page, where you can view and update your information. Click “Change” to add your Areas of Concentration, then save your information.
    • Click “eLearning” at the top of your profile page to go back to the ACCC eLearning portal. In the box on the left side of the screen, click on the “Cart” link.
    • The green box in the upper right corner of this page will indicate “You are registered!” for this course. Congratulations!

    If You Have An ACCC Account:

    • Please click the orange “Log In” button on the left side of this screen. You will be taken to the main login page that displays your email and password. Click the “Log in” button.
    • You will be automatically redirected back to this course/webinar <specify> page, and the green box in the upper right corner will say that “You are registered!” for this course. Congratulations!

    PRO TIP: If you save your ACCC password to your computer and remain logged in, you can register for additional webinars and courses in a matter of seconds—with just one click!

    For the best registration and viewing experience, please use Chrome, Edge, or Safari web browsers. Internet Explorer Users may experience difficulties accessing the webinar.

    Once you complete your registration, you will receive an email from ACCC eLearning, which contains information on how to access this course/webinar <specify>. For assistance with registration or if you do not receive an email, please contact registration@accc-cancer.org.

    In the final webinar, we heard from experts Jordan Karwedsky, Financial Counselor, Green Bay Oncology, Wendi Waugh, BS, RT(R)(T), CMD, CRT, Administrative Director of SOMC Cancer Services & Ambulatory Infusion, Southern Ohio Medical Center, and Dr. Michael R. Gieske, Director of Lung Cancer Screening. Listen in on the discussion around prior authorization challenges in biomarker testing, importance of providing access to biomarker testing for underserved populations, how biomarkers are shaping the future of medicine, as well as what can be done at the policy level to allow for more access.  

     

    Jordan Karwedsky

    Financial Counselor

    Green Bay Oncology

    Jordan Karwedsky is one of seven financial counselors at Green Bay Oncology, and has worked in oncology for 11 years.  She joined Green Bay Oncology in their billing department and transferred to the clinical setting as a financial counselor.  Jordan is part of a team that is responsible for obtaining authorizations for all medications, labs, diagnostic imaging, and radiation treatment. This team also supports patients by enrolling them into local and national foundations, and pharmaceutical company co-pay card and patient assistance programs to assist with medication out of pocket costs.  Jordan’s biggest role is being an advocate for the patient.

    Jordan participates in a number of committees within the organization including the Clinical Practice Committee, as well as works with the providers to update Clinical Pathways.   She has presented on financial advocacy at the 2016 ACCC National Oncology Conference, consulted with other cancer centers to develop their financial counselor programs, worked with outside donors to obtain funding for an internal patient assistance program.

    Wendi Waugh, BS, RT(R)(T), CMD, CTR

    Administrative Director of Cancer Services & Community Health and Wellness

    Wendi Waugh, BS, RT(R)(T), CMD, CTR, is Administrative Director of Cancer Services & Community Health and Wellness at Southern Ohio Medical Center in Portsmouth, Ohio. She brings more than 30 years of experience in healthcare to this role. She began her career in medical imaging but has spent the last 28 years in oncology. Her passion for community health and community development led her to assume a larger leadership role at Southern Ohio Medical Center in 2013, when she assumed leadership of the Community Health and Wellness teams.

    A 13-year survivor of breast cancer, Wendi special interests include community development, public speaking, leadership, dance, fitness, hiking, and biking, and spending time with her family.

    She is a graduate of the Radiologic Technology Program at Shawnee State University and received her training for radiation therapy at Weber State University. She completed her Bachelor of Science degree in Health Administration and Health Informatics from Kennedy Western Reserve. Wendi is also a Certified Cancer Registrar and Certified Medical Dosimetrist.

    Michael R. Gieske, MD

    Director of Lung Cancer Screening, St. Elizabeth Physicians

    Michael Gieske, MD, is the Director of Lung Cancer Screening at St. Elizabeth Healthcare. He has worked with his team at St. Elizabeth Healthcare to build one of the most successful lung cancer screening programs in the country. In addition to his daily practice, he is the lead physician at his site in Ft. Mitchell, Ky., and the East Division Physician Director of Primary Care, overseeing 10 sites.

    Dr. Gieske sits on the boards of the American College of Radiology, GO2 Foundation, Lung Ambition Alliance, NLCRT, LungCan, and the Rural Appalachian Lung Cancer Screening Initiative. He is a dedicated advocate for lung cancer survivors and caregivers, raising awareness and promoting policy to bring hope to patients with lung cancer and those at risk for lung cancer.

    He graduated from University of Louisville Medical College in 1984, then completed his Family Practice Residency at St. Elizabeth Medical Center in Edgewood, Kentucky in 1987. 

    Sarah Hudson-DiSalle, PharmD, RPH (Moderator)

    Oncology Pharmacy Manager, Medication Assistance Program and Reimbursement Services, The James Cancer Hospital and Wexner Medical Center, Ohio State University Department of Pharmacy

    Dr. Hudson-DiSalle is the manager in the Medication Assistance Program and Reimbursement Services at the Wexner Medical Center and James Cancer Hospital in Columbus, OH. She is responsible for managing and advocating for the Medication Assistance Program for patients who cannot afford their medications, as well as overseeing reimbursement authorization for off label medication use, high dollar therapy usage, infused medication and medication denials. Dr. Hudson-DiSalle serves on the Board of the Charitable Pharmacy of Central Ohio, the Health Policy Committee of the Hematology/Oncology Pharmacy Association (HOPA), and the Legislative Committee of the Ohio Society of Health System Pharmacists.