Advocating for Patients:
Obtaining an Override from Insurers & Employers
Thursday, March 10
5pm CT/6pm ET
Recording available here.
Learn how to advocate for your patients to get overrides and continue successful treatment.
During this 30 minute webinar, template letters and a review of the request and appeal process will be provided by CSRO Insurance Committee members Julie Baak, Nilsa Cruz and Karen Ferguson, and moderated by CSRO President Madelaine Feldman, MD, FACR. These industry experts will also share tips from their experience on-the-job that will arm attendees with solutions and options for patients.
About Our Experts
Julie is an expert in Rheumatology Practice Management and a nationally recognized leader in resolving drug access issues. She has worked with the PBMs and against them, so she knows both sides of the specialty drug spend. She is an accomplished speaker, advocate, and holds direct contracts with several large employers for infusions drugs. Julie has extensive experience in many sectors including banking, finance, and healthcare. In 2015 she built a large Rheumatology practice from the ground up and delivers a patient experience that is nationally recognized. Her advocacy efforts have been highlighted on the local news and nationally with advocacy orgs, as she will do whatever it takes to serve patients and provide access to care. She has direct contracts in place with several major employers in Saint Louis, Missouri. In the climate we find ourselves in with Payer mandates that make things extraordinarily difficult to navigate, she takes them on, one patient at a time, with grace and success.
A former nominee for the ARHP Ann Konkel Advocacy Award, Nilsa Cruz has created a solid track record for advocating for Rheumatology practices and patients at the local, state, and national levels over the last 20 years. Her successful campaign to advocate for Rheumatology patients is a result of her ability to bring the right people together, even before they know they have shared interests. Additionally, her 12 years of experience as a Pharmaceutical Sales Consultant has taught her to follow through and “close the deal” when applied to advocacy. Nilsa’s compassion, sense of collaboration, energy, and enthusiasm, know no bounds, and rheumatology patients are the clear beneficiaries. She can identify an emerging problem, especially in the realm of insurance companies, PBMs, and patient access to therapy, and quickly educate others about the causes and potential solutions. She understands the ins and outs of running a private rheumatology practice, which she has done for the last 20 years as Practice Manager for her husband’s rheumatology practice in Milwaukee, WI.
Karen is a proven health care executive and entrepreneur with over 20 years of leadership within the health care industry. As the practice administrator for the last 17 years to one of the largest rheumatology practices in the Pacific Northwest, Karen led her organization to earn the national recognition for quality care, “NCQA Patient-Centered Specialty Practice Recognition” which distinguishes practices that communicate, collaborate, and integrate care in ways that demonstrates constant improvement through communication, coordination, and providing access to care. Currently, Karen continues her passion as a consultant and passionate patient/doctor advocate. She founded a 501 C4 non -profit organization, Our Stories Rx, as an interactive storytelling platform that brings together patients, community clinicians, independent pharmacists and local employers who are being harmed by the predatory pharmaceutical benefit management practices and perverse incentives that drive up cost and limit best treatment options.