October 17, 2018
My name is Andrea Orjuela, Sr. Medical Secretary. This post is to give you a look into the inner workings of the MS Center.
At the Weill Cornell MS Center we work hard to provide the best care and ensure that the process runs as timely and smoothly as can be. Here is what we do to achieve that.
When you come in to see our physicians and go over all the options for treatment, and you come out with a decision on the best medication treatment that works for you, that’s where we step in!
There next steps are as follow
We will get an enrollment form for the medication which you will fill out.
We then send in your enrollment form to the pharmaceutical company that makes that specific medication. We do this so that they can enroll you in their medication program so that they may assist with insurance approval and offer financial assistance for drug coverage if needed.
Next step, would be getting in contact with the insurance company to obtain prior authorization. A prior authorization is an approval that the insurance gives us to cover the cost of the medication. This step is not always the most pleasant joyride! Because there are no uniform guidelines for approval and the requirements and documents needed can vary widely between different insurance providers and even between plans offered within the same insurance provider. But we are very committed and work hard at getting your medication approved.
After receiving authorization for your medication the next step is to send a prescription over (we send this usually by electronic prescription) to the to the designated specialty pharmacy. A specialty pharmacy is a pharmacy that is designated by your insurance to procure and provide the medication. This is often not your local neighborhood pharmacies. They are mostly mail order and they will send the medication overnight once the requirements are met. Now depending on the medication, we either have them send medication to our office, (which happens when it is an infusion medication) if not it would be sent to your home. They will ship it only after you consent and authorize for that to happen with the specialty pharmacy.
Now there are some medications that need to be infused in the office. The process is pretty much the same with the exception that we need to coordinate a date for you to come in and we need to look for that availability.
So there, now you know the process! Overall, the process of getting your medication should take about 2 weeks unless there are some bumps in the road, but even if there are we always manage to get what you need.
A prior authorization is also required from most insurance companies for MRIs, blood tests usually do not require this and can be done at our infusion suite at the time of your visit.
If you need to talk to us at any time, you can call us, but sometimes the lines maybe busy because we are doing the above for our patients! You could leave a message and we will get back to you as soon as we can, but an easier way to get in touch with us is through sending us a message through Weill Cornell Connect.