Part of the series: Allergy, Asthma & Immunology Innovations Podcast

This podcast was made in partnership with Allergy & Asthma Network and in collaboration with the National Association of Medication Access and Patient Advocacy (NAMAPA).

We thank Amgen for sponsoring this episode. While they support the show, all opinions are our own, and sponsorship doesn’t influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.


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Are you frustrated by the health insurance approval process for medication?

Many patients may not know what their doctors are doing behind the scenes when dealing with health insurance, and many doctors may feel overwhelmed by this process. There is a silver lining! Tools exist to help patients and providers better navigate the complexities of health insurance.

Elizabeth Johnson joins Dr. G and Kortney to share her expertise on overcoming the hurdles of securing medication approvals. She explains the biggest challenges healthcare providers face when working with insurance companies. She offers practical tips to navigate the approval process more efficiently.

Together with Dr. G, they discuss the lack of health insurance education for providers and the burden this places on medical staff. They also explore available resources and tools for healthcare professionals and stress the importance of incorporating insurance education early in medical training.

What we cover in this episode about health insurance from the provider’s side:

  • Provider Challenges: Elizabeth explains the common hurdles doctors face in securing medication approvals, from paperwork to insurance denials.

  • Navigating Insurance Companies: We explore the complexities of insurance approvals, from prior authorizations to the importance of good note-taking.

  • NAMAPA Toolkit: Elizabeth introduces the NAMAPA toolkit, designed to assist healthcare providers in navigating all aspects of health insurance.

  • Insurance Education: We highlight the need for insurance education during med school, residency and fellowship.

  • Health Insurance Resources: Elizabeth shares strategies to ensure healthcare professionals have the tools to handle medication approvals and the resources available from pharmaceutical companies.

About our health insurance expert - Elizabeth Johnson

Elizabeth Johnson is a Licensed Practical Nurse with expertise in medication access and healthcare systems. She holds multiple certifications, including Certified Professional Coder (CPC), Prior Authorization Certified Specialist (PACS), and Board Certified Patient Advocate (BCPA). With a passion for education, Elizabeth trains healthcare facilities and physician practices on acquiring biologics and biosimilar medications, always prioritizing patient access to treatment.

More resources health insurance for doctors and patients:

 

Here are the modules of the insurance toolkit discussed in the episode. 

 
 

Timestamps

Navigating health insurance for doctors - episode timestamps

01:45 Introduction to Elizabeth Johnson

02:58 Common challenges doctors face when securing medications for patients

05:41 The challenge of dealing with insurance companies

09:08 Differences in the approval process for various medications

14:00 Overview of the NAMAPA toolkit

17:08 Breakdown of the NAMAPA toolkit modules

21:11 Why insurance education should be included in medical training

22:11 Resources provided by manufacturers and pharmaceutical companies

25:46 Strategies to introduce this information earlier in medical careers

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Ep. 90: Challenges in Diagnosis and Treatment of Chronic Urticaria in Skin of Color

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Ep. 88 - How to Get Your Meds Approved: Appealing Insurance Denial