Existing Patients: Report 2023 insurance changes to avoid disruptions

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Inside PTC Cares™ Video Transcripts

INSIDE PTC CARES™ THE EXTRA MILE WITH CARLA

LET’S GET TO KNOW THE PTC CARES™ CASE MANAGERS LEARN HOW THEY HELP FAMILIES LIKE YOURS

HELPING FAMILIES FIND TREATMENT

Verifying Insurance Coverage

CARLA: I’ve got to make sure that all my upcoming prior authorizations are in order, making sure that I’m sending off the paperwork to the doctor’s office, having them sign off on it,…

Collecting Info to Support the Prescription

CARLA: …making sure that I get the necessary clinicals to kind of assist with completing that, sending it off to them so that they can kind of, you know, QA it, sign off on it, and then we’ll send it right on over. That’s what we’re here for, right? To make this as easy and seamless for our families as possible.

As Easy and Seamless as Possible

RACHEL: That’s so nice. They don’t have to call the insurances to follow up or anything. They just give you a call.

CARLA: Yeah, we’re supposed to be that single point of contact.

Single Point of Contact

CARLA: And I like to kind of like, reassure them at the beginning, like, “Hey, you need anything? Please give me a call. If I don’t know the answer, I’m going to get the answer for you from somebody. Okay? So no matter what, come to me first, so that we can kind of play, you know, damage control.”

Making the Process Easier

CARLA: I always tell them “I want to do the heavy lifting for you, so you don’t have to.” So. And that’s like, the best compliment I always get from my family is they’re like, “I didn’t even know that it’s that time of year again.” You know what I mean? It’s like. So they’re like, “It’s done already?” I’m like, “Yup, all for another year. You’re good.”

RICK: “Nothing I had to do?”

CARLA: “Not at all.”

RACHEL: “It’s so simple.”

DO ANY EXPERIENCES STAND OUT TO YOU?

RICK: Hey Carla, have families helped you realize your work has a big impact?

CARLA: Absolutely. You know, we all as Case Managers get those calls and we realize at that moment the impact that we have on our families.

RACHEL: Yeah, I had a family call a couple of weeks ago and they said, “You know, you said call if you, if we run into any issues or if there’s something that might be kind of unaffordable for us.” And they said, “You know, we were trying to schedule our shipment and the cost was astronomical.”

Reviewing Out-of-Pocket Costs

RACHEL: “We definitely can’t afford that. And we wanted to see,” you know, they said, “is there anything you can do to help us out?”

Copay Assistance Program

RACHEL: We looked into it a bit more and realized, you know, there was the copay card hadn’t been applied to their account. And it was a quick, simple fix to get the—.

CARLA: Handle that situation.

RACHEL: Yeah, handle that situation. I worked with our pharmacy partners and it was a smooth sail process. You know, the very next day we were able to schedule that shipment. The family called and said, “Wow, with the co-pay card, the cost was way more affordable to us.” Yeah.

CARLA: Absolutely, it always brings me full circle whenever I hear from mom. She’s like—when I get the thank you’s, you know? “Thank you. You’re always there. You’re a constant.”

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