Payors | Avella Specialty Pharmacy


Payors Overview

An important part of the services we provide to our patients is assistance with their medication reimbursement support needs.

Our staff is experienced in payor policies and procedures, prior-authorization guidelines and utilization-management programs. Our team serves as the primary point-of-contact for physician questions regarding medication reimbursement for patients.

We accept all major insurance plans including

  • Medicaid
  • Medicare (including Part D and Part B)
  • Commercial insurance
  • Carved-out pharmacy programs administered by PBMs
  • Manufacturer-supported patient assistance programs
  • View our Performance Drug List

Payor Benefits

Our goal is to provide exceptional care to patients and their treating physicians at a reasonable cost. Because of our size, we are able to secure competitive pricing for payors. Our commitment to service excellence has been rewarded by consistent referrals from leading institutions and providers. Our overall approach provides significant benefits to payors including:
  • Improved relations with your provider and patient constituents, based on the quality of care we provide
  • Coordination of benefits, pharmacy billing and reimbursement counseling
  • Improved clinical outcomes, based on the disease specific expertise of our staff and the robust nature of the clinical programs we implement on behalf of your patients
  • Lower costs due to our competitive product pricing, adherence to utilization management protocols, and reduction in medication abuse and waste
  • Improved consistency of care delivered to your members, based on our strict quality control and continuous quality improvement processes

Patient & Provider Benefits

We are dedicated to delivering exceptional service to our provider partners. For providers, we offer a number of benefits, including:
  • Reliable source of in-depth pharmaceutical information
  • Extensive reimbursement support services
  • On-going source of staff education programs
  • Partners in securing optimal patient outcomes
  • Co-payment vouchers and manufacturer-assistance programs
  • Co-pay assistance through foundations and pharmaceutical manufacturers
  • Unit-dosed packaging
  • Access to clinical pharmacists 24 hours a day, seven days a week

For more information please contact our Managed Care department at: managedcare@avella.com