Navigating through the insurance coverage process can be difficult and complex. PATHWAY PLUS is a complimentary, single resource for reimbursement support and patient services. Our PATHWAY PLUS reimbursement counselors provide the following services to both you and your patients:
- Benefit Investigation – PATHWAY PLUS conducts a Benefit Investigation to help you better understand your patient’s health plan coverage of Abbott Nutrition products and any associated out-of-pocket costs. PATHWAY PLUS can also determine if prior authorization is required by the health plan. To initiate a Benefit Investigation, please complete and sign the Request Form that pertains to the product you have recommended and fax to PATHWAY PLUS at 855-752-9885 or call 855-217-0698 (Monday - Friday, 8:30am-5:00pm EST).
- Prior Authorization Support – PATHWAY PLUS assists with the prior authorization process to help patients get the appropriate product that you have recommended. When Prior Authorization is required, PATHWAY PLUS assists with the collection of required information including payer specific Prior Authorization forms. Additionally, PATHWAY PLUS monitors the process by contacting the payer to confirm they received all required information and follows up with the payer to determine the outcome.
- Appeal Process Research and Support – PATHWAY PLUS reviews information and contacts the payer to understand the cause for denial of Abbott Nutrition products and the payer-specific appeal or resubmission process. PATHWAY PLUS can provide next steps to you and follow up with the payer to determine the outcome of the claim appeal or resubmission.
- Billing and Coding Information and Support – PATHWAY PLUS provides published codes and reimbursement information including HCPCS codes and NDC-format codes for Abbott Nutrition products.
- Alternate Funding Research/Referral – PATHWAY PLUS researches and identifies other payers or programs that may help with some of expenses. When no other funding options exist, PATHWAY PLUS assesses the patient’s eligibility for the Abbott Nutrition Patient Assistance Program.