How Optimizing Your Copay Program is Like Playing Guitar (Part 2)

This is the second part of my; “How is copay related to playing/building guitar” series… The entire patient incentive copay reimbursement process seems so simple on the outside (it’s just a coupon right?) but the process is incredibly complex on the inside. It takes great expertise to efficiently maneuver through setting up the program, analyzing the outputs, and optimizing the results to match brand goals.

You can say all of those things about playing guitar. It looks like a pretty simple instrument. It’s just a neck and body with most having six strings attached to it. I mean how hard can that thing be to play? It seems simple… only seven primary notes (12 notes overall). What do you need those for? Once you look more closely at the guitar you notice things you may have missed at first glance:

·?????? What are all of those silvery metal things running across the neck?

·?????? Why do most guitars have 22 of those (frets) and others have 24??

·?????? Why six strings? And why do I now see ones with seven or eight?

·?????? Why can you play each note in two different places on each string?

·?????? Why can you play the same note in a dozen places on the six strings?

·?????? What is a chord (series of notes played together) and why do I need to play chords?

·?????? Why are some chords the same as the twelve notes and many others different??

Need I go on? The guitar is not so simple after all. Pick one up next time you are in a store and try to play it. The good news is if you have the desire and drive, with a little instruction and plenty of practice, you may be able to play some simple chorded songs in just a few weeks. But if you want to go on to more complex songs prepare to spend great amounts of time (like years, maybe a lifetime) practicing.

The patient copay program process is a similar animal. It may be easy to understand the basics of copay but much harder to understand the NCPDP system processes, its flaws, the potential problems you might encounter, picking a vendor, devising the best offer for the brand’s situation, implementing the complex business rules, analyzing your results, stopping and preventing fraud, auditing your claims, and optimizing your offer once the data is in. Again, plenty of questions here to be asked, just like the guitar. It is anything but… just a coupon!

Both topics are deceptively easy on the outside but require so much expertise and experience to master. It would be extremely difficult to master either one without proper guidance and plenty of time invested…

Note: The guitar I hold in the picture was custom-built for me by Omer Deutsch who owns OD Guitars (https://www.od-guitars.com/). Omer is an incredible and precise artist. He hand-built the guitar according to my specs starting from a few pieces of wood I picked. It was an incredible process and the finished guitar was not only perfect for me, but it came out almost exactly like the one he mocked up for me when I picked out the wood. A “perfect forecast” I would say! I highly recommend him! ?

Stay tuned for my next article in this series where I take you through the process of building a custom guitar from scratch and the parallels of putting together a copay program the same way.

For a wealth of information on Copay Program Optimization please visit our website: https://alpha1c.com/category/best-practices/

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