Benefits Navigation –
It’s complicated

M.L. Robertson Consulting, Inc. aims to simplify information and focus on key skills for practice

Benefits Navigation

 

Benefits navigation is a series of actions that focus on helping a patient to coordinate funding assistance for a prescribed drug, assistive device, or service not covered by universal health care.

This involves working with a variety of benefit providers – insurers, public drug plans, provincial funding programs, and patient support programs. Knowing how each of these sectors work and how to work with them effectively supports more timely patient care and improved adherence to therapies.

Benefits navigation can include:

 

Investigating coverage of a product on someone’s plan

Informing patients of public plan options

Coordinating necessary paperwork

Linking patients with patient support programs

Advocating for coverage or better access

Benefits navigation is something we often always think of as a practice or a skill, but it is quickly growing into a field all its own.

Drug access navigators are now employed in hospitals across the country. Reimbursement coordinators and case managers work in the private sector to maximize and coordinate benefit options. Many professionals also do the work of helping patients sort through drug coverage as a growing portion of their regular work: pharmacy technicians, nurse navigators, hospital social workers, medical admin assistants. The tasks involved in navigation are growing more complex as benefits systems tighten. Yet there are few training options available.

M.L. Robertson Consulting, Inc. aims to fill that gap by providing practical, case-based training opportunities for a range of health care professionals on the essentials of benefits navigation.

"Mary Lou's significant experience and skills in the complex and ever changing landscape of drug access sets her apart.
As payers change the rules for reimbursement, Mary Lou's broad base of knowledge brings significant value along with a highly collaborative and communicative style."

Simon Roberts, National Sales Manager

Women’s Cancer, AstraZeneca

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Mary Lou Robertson BA, BSW, RSW

mlr@mlrobertson.ca


© 2017 M.L. Robertson Consulting, Inc.