Pharma in the field: Tierra's story

Tierra's dedication to helping manufacturers and providers navigate patient access challenges has never wavered, even as the COVID-19 pandemic has disrupted her favorite part of her job—traveling and meeting people face-to-face.

Field Access Specialists (FAS) like Tierra can be a secret weapon for overcoming patients' barriers to access—but only if manufacturers take advantage of the knowledge and skills these unique representatives offer. A look at Tierra's work shows why.

Leveraging a diverse background

The FAS role at Xcenda draws professionals from a variety of backgrounds. Tierra is a case in point. The former accounts receivable coordinator for an oncology practice joined Xcenda in January 2019. She has a hands-on understanding of the relationship between the practice and insurance companies from her work handling prior authorization, billing procedures, and insurance follow-ups. She is also a certified pharmacy technician, meaning she can provide a thorough education on any drug program she supports as a FAS.

“We're here to help. We collaborate with many of our client's key stakeholders, such as the pharmaceutical sales team, to support providers through any patient access challenges they run into," says Tierra. "Whether that's providing information or helping them dig deeper into denials and authorization issues, our work means that they're not alone. Each practice recognizes that they have knowledgeable support dedicated to their success. All they have to do is reach out."

Supporting providers in challenging times

Traditionally, the FAS world is hands-on. Representatives travel extensively to cover their regions, visiting offices and building face-to-face relationships with the staff at each practice. But Tierra's world has changed as a result of the COVID-19 pandemic. Phone calls, voicemails, and web conferencing have replaced visits to a practice.

While most doctors' offices are comfortable submitting appeals, many don't understand how to best respond to an appeal denial to ensure processing in their favor or how many options they have after a denial. Supporting these providers means walking them through the appeals steps and explaining the exception process. She's currently focused on educating providers on the manufacture's support program services and overcoming payer utilization management obstacles to support patient access to therapy.

“I love traveling and being able to go into the office, talk to the contacts, and see their faces, especially when there's an issue. When we show up, they breathe a sigh of relief and they know that they have somebody there to help."

Tierra, who supports sites of care across the southeastern United States and Puerto Rico, is currently working on a medication used to treat Parkinson's disease. Dealing with drug access in Puerto Rico in particular has been challenging, as patients waiting for their medication have been reluctant to answer calls from a specialty pharmacy with U.S. phone number who are trying to schedule delivery.

“I try to figure out what's best for the manufacturer and the provider's office and bring forward solutions to support their needs. They all have different needs—some are more hands-on; others are more laid back—so I stay flexible and play into their styles."

Navigating a day of detail

Tierra's behind-the-scenes efforts keep those relationships flowing smoothly.

She starts every Monday checking reports for any updates that might have come through since she set up her call plans to close out the previous week. Every morning, she checks the status on prior authorizations and outstanding cases and then moves on to work through her call plan.

Throughout her day, she collaborates with a number of other roles in the patient access sphere to ensure seamless coordination. While she doesn't work directly with patients, she does have quite a bit of contact with doctors' offices.

The FAS world thrives on detail and documentation. Tierra regularly communicates with office staff to check the status of cases and identify any outstanding needs. Tierra works from a dashboard that generates three to four reports that keep her ahead of the needs of her provider offices.

The fuel behind the FAS

FAS effectiveness depends on effective training. Tierra has gotten the most benefit out of role play training from Xcenda that simulates issues the FAS frequently encounters on the job.

An FAS must stay abreast of payer coverage, prior authorization requirements, and step edits related to the drug they support; all of this must be in a compliant manner. Knowing when and how to communicate them is an art. Role play helps refine communication skills and teaches the FAS to think on their feet to provide the best support.

“I just like to see the wins. Anytime I can see a patient case where the drug is ready to ship, I get excited. At that point, the only thing that's left is to contact the office to let them know. My goal every day is to get all my patient cases to that status because that means that we're at the finish line, and I've helped support patient access."