Patient Choice Policy
GLHF respects patient and family freedom of choice. When the need for factor distribution to a patient for use at home is identified, patients and families have a right to choose their vendor.
Questions to Ask When Choosing a Factor Provider
When choosing a factor provider it is important to ask both the factor provider and your insurance provider several questions. The following is a list of questions that we usually suggest you ask when choosing your provider. We encourage you to “interview” more than one provider to insure that you are receiving the best service and care for you or your child. Compare the prices and services of each agency carefully before making your decision. Also it is important to note that your insurance company may dictate your options so it would be a good idea to check with your insurance provider before contacting the factor providers. GLHF does not recommend any vendor, product or HTC.
Factor Provider Questions:
- Are you a preferred provider under my insurance plan?
- What’s your policy on co-pay and deductible costs? Do you have a financial assistance plan?
- What are your hours of operation? Do you have a toll free customer service line that is available 24 hours a day?
- What is the standard delivery time (24 hours, 48 hours, etc.)?
- What is your policy on emergency orders?
- Do you have an emergency plan in place in the event of a natural disaster or other emergency?
- Do you have an adequate supply of the factor I need on hand and in the right assay size?
- Are all ancillaries included with my order?
- What is the cost per unit for my clotting factor?
- What additional ancillary services do you provide? For example, nursing or physical therapy.
- What is the cost for these services?
- Will I receive copies of all billing invoices?
- Do you participate in the Patient Notification System for clotting factor recalls?
Insurance Provider Questions:
- Do you have a list of preferred providers for clotting factor?
- Is my clotting factor covered under my major medical plan or my prescription plan?
- If it is covered under my prescription plan:
- Do I have a separate deductible?
- Is there a preferred drug list?
- What tier level is clotting factor covered under?
- What is my co-pay or co-insurance? Is there a maximum out-of-pocket cost?
- Is there an annual cap on major medical or prescription drug costs?
- What are my out-of-network benefits should I choose a factor that is not a preferred provider?
- Is a prior authorization required for clotting factor?