Video 3: Specialty Distributor with Buy & Bill Transcript
SUPER: The Access and Acquisition Series: Buy & Bill acquisition process
SUPER: Specialty Drugs
VISUAL: A park scene appears, with the wind blowing. A leaf blows into the frame. The leaf blows past
faces of patients and the words Specialty Drugs slide in from the right. The words Specialty Drugs are
now in full view, while the figures continue to slide to the left. The people continue to slide to the left.
The people slide off to the left as a clipboard animates in.
VO: Accessing specialty drugs may be a new experience for your practice, but understanding how to
integrate these specialty drugs into your practice can help provide additional options for your patients.
Obtaining these drugs requires processes that may differ from oral medications.
SUPER: Commercial Insurance, Medicare, Medicaid
SUPER: Medical Benefit
VISUAL: Supers appear onscreen with their corresponding icons. The icons fall off the screen. The HCP
animates in. The Medical Benefit iconography animates in. The Medical Benefit icon and words swoop
up out of the frame.
VO: The method you will use to acquire these drugs is dependent on your patient’s insurance coverage.
In this video, we’ll discuss the specifics of acquiring a specialty injectable drug when your patient’s
insurance covers it under the medical benefit.
SUPER: 3 options
SUPER: Buy & Bill
SUPER: AOB Assignment of Benefits
SUPER: ASA Alternative Site of Administration
VISUAL: Paper swirls around a vial that spins and comes into the frame, and the words 3 options appear.
Buy & Bill and its icon appear in the center of the screen. AOB Assignment of Benefits and its icon
appear in the center of the screen. ASA Alternative Site of Administration and its icon appear in the
center of the screen.
VO: Under the medical benefit, there are three options: the Buy & Bill process with a specialty
distributor, an Assignment of Benefits, or "AOB," or through an "ASA," which stands for Alternative Site
of Administration.
SUPER: Buy & Bill
SUPER: Specialty Distributor
VISUAL: The Buy & Bill icon is at the center of the frame. The Buy & Bill text and icon shift to the left as a
woman on the phone comes in from the right. A cube comes in from the left, shifting focus away from
the woman on the phone. The building increases in detail revealing the specialty distributor building
with the words Specialty Distributor appearing next to the building.
VO: Let’s begin with Buy & Bill. Buy & Bill is the most common acquisition method under the medical
benefit. The process is known as Buy & Bill as your practice will purchase the drug directly from a
specialty distributor and bill the payer for reimbursement.
SUPER: 5 Key Steps
SUPER: 1 - Benefit Verification and Payer Contract Review
2 - Prior Authorization
3 - Purchasing and Stocking the Drug
4 - Administration
5 - Billing and Reimbursement
VISUAL: Copy appears onscreen. A piece of paper is seen with the words Benefit Verification on it. Two
icons appear on either side. A hand checks a box on the piece of paper. The icons all shift clockwise and
an image of vials in a box appears; one is out of the box more than the others. The images shift again—
clockwise—and a vial and syringe take the center of the frame. The image shifts clockwise again while a
hand appears with a bill. The syringe and paper disappear and only the box with vials and a bill are
onscreen. The bill swoops away from the rest of the imagery on the frame.
VO: There are five key steps in the Buy & Bill process: benefit verification and payer contract review,
prior authorization, purchasing and stocking the drug, administration, and finally, billing and
reimbursement.
SUPER: Medical Benefit
VISUAL: A piece of paper swirls onscreen. A hand reaches for the swirling paper and writes on it. Two
healthcare professionals (HCPs) stand looking over the paper. One HCP slides off screen to the right; the
other remains. The HCP receives a clipboard. The Medical Benefit iconography reappears. The Medical
Benefit icon shifts as a manila folder with Prior Authorization appears.
VO: First, your practice will conduct a benefit verification. This step is always needed to confirm your
patient’s coverage and detail any prior authorization requirements. For drugs covered under the medical
benefit, a prior authorization is usually needed.
VISUAL: The manila folder shifts to the left and paperwork comes in from the right. The paperwork goes
into the folder. A doctor writing a letter appears from the right. The doctor fades away and the letter
goes into the manila envelope. Charts appear from the right. The charts go into the manila folder. A
paper with Test Results appears from the right. The test results go into the manila folder. A paper and a
vial appear from the right. The paper and vial go into the manila folder. A checklist and hand appear
from the right. A stamp appears and the paper swoops up.
VO: To obtain a prior authorization, some payers require the completion of a specific form, and others
require documentation such as a letter of medical necessity, chart notes, test results, or the Prescribing
Information for the drug. Your patient’s payer should supply you with a list of requirements to properly
complete their prior authorization process.
VISUAL: The prior authorization folder returns to the center of the frame and the stamp presses on the
folder leaving an approval check. The stamp increases in size. The stamp moves out of the frame. A bill
comes out of the folder. Another bill comes out of the folder and sits below the first bill. The folder now
says Payer Contract. The papers return to the folder and fall on the HCP's desk. The shot zooms in on the
folder as the papers file into it. The folder swirls on the screen.
VO: While verifying your patient’s benefits, your practice should confirm contract details with the payer
to understand reimbursement for the administration and product costs for the drug. These contracts
should be in place for all the payers your practice works with.
SUPER: Specialty Distributor
VISUAL: A hand holding a checklist appears. Another hand with a pen appears. A large box animates
above the paper. The hand checks off boxes on the paper. The paper floats out of the hands and swirls
upward. The Specialty Distributor icon appears. A truck pulls out of the Specialty Distributor warehouse.
The truck drives away from the Specialty Distributor warehouse. The box opens and a vial rises out.
VO: Once the payer contract is confirmed and prior authorization is approved, your practice will contact
a specialty distributor to acquire the drug. Your ViiV team can supply you with a list of specialty
distributors to work with.
VISUAL: The vial rotates above the box. The vial returns and the box closes. The box appears in its
storage container. The HCP is shown to the right of the container.
VO: Your practice will then place an order for the specialty injectable drug to stock on site so it is
available when needed.
SUPER: What are the return or payment terms with the specialty distributor?
When will the product be shipped?
Is the patient scheduled for administration after the shipment arrives?
Does the product require special handling or storage?
VISUAL: The HCP reviews the boxes in the container. Papers begin swirling around the HCP. Papers
begin swirling around the HCP. A paper sits on the left of the screen with a list of questions beginning to
appear on the right. The paper is replaced with a calendar and a hand truck with a box. Another
question appears to the right. The hand truck disappears and a person in a chair appears behind the
calendar. Another question appears on the right. A thermometer, vial, and box appear on the left.
Another question appears on the right.
VO: There are a few key questions to keep in mind as you’re working with the specialty distributor on
your order. What are the return or payment terms with the specialty distributor? When will the product
be shipped? Is the patient scheduled for administration after the shipment arrives? Does the product
require special handling or storage?
VISUAL: A calendar appears. A syringe lands on a day on the calendar. The calendar page turns to reveal
a patient sitting across from an HCP. The patient and HCP slide offscreen to the right and an envelope
and bill appear on the left. The bill is now in the center of the screen. The bill starts to go into the
envelope.
VO: Once your practice has ordered or stocked the drug, you can schedule an administration
appointment for your patient. After administration, your practice will bill the patient's insurance to get
reimbursed for the administration and product costs for the specialty injectable drug.
SUPER: Product
SUPER: Administration
VISUAL: The bill folds into the envelope. The envelope seals and a hand remains in the frame. A
magnifying glass looks at the barcode on the bottom right corner of the envelope. A billing code is
revealed.
VO: Your practice is responsible for collecting any co-pays or coinsurance for the product, office visit, or
additional administration fees from the patient. To facilitate accurate reimbursement, ensure your
billing codes are correct.
VISUAL: A woman appears on the phone. Between the woman on the phone and the bill, a man in a call
center appears in the center of the screen, dividing the frame into three parts. The bill on the left side of
the frame swoops to the right of the screen over the two people on the phone. An office setting
appears. The envelope continues off the screen and a check mark appears to the right of the man in the
office. The envelope flies into another office with another person working on a computer. The envelope
swoops past the man on the computer and another check mark appears on screen.
VO: You can contact your ViiV team to support you with billing information before submission to the
payer. Some provider offices even assign specific individuals within the practice to own different steps of
this process. Working as a team can help with accountability and efficiency for the Buy & Bill process.
SUPER: Buy & Bill
VISUAL: The man in an office and man in a call center appear in the background as a doctor appears in
the center of the screen with a barcode and the words Buy & Bill in the top right. The doctor moves to
the left of the screen while a cell phone with the word ViiV moves to the center. The frame transitions
with the flip of a page from the top right. A container appears next to the barcode. A box is removed
from the container and a vial comes out of the box. The box returns to the container. The container
slides off the screen to the left and the barcode moves into a person's hand to the right.
VO: If it is your practice’s first time doing the Buy & Bill process, we recommend connecting with a
member of your ViiV Team before beginning to help prepare your practice. The Buy & Bill process allows
your practice to have the specialty injectable available on site and ready for appropriate patients.
SUPER: You may have other options
SUPER: Medical Benefit
SUPER: Assignment of Benefits (AOB)
SUPER: Assignment of Benefits (AOB), Specialty Pharmacy, Specialty Distributor, Specialty Drugs
VISUAL: The hand gestures to the right and the hand and barcode move off screen. The camera zooms
out from the hand revealing the Medical Benefit icon. The camera pans around the HCP. The Assignment
of Benefits icon appears. The specialty pharmacy and specialty drug icons begin forming. The screen fills
with the flow chart of assignment of benefits to specialty pharmacy to specialty drug. The camera
continues to pan, revealing the flow chart of assignment of benefits to a specialty pharmacy to specialty
drug. Specialty distributor is crossed out in the background.
VO: Another method that may be covered by your patient's insurance under the medical benefit is
Assignment of Benefits, or AOB. An Assignment of Benefits is a process under the medical benefit that
may allow you to access a drug through a specialty pharmacy instead of a distributor.
VISUAL: The Specialty Distributor icon fades away. The Alternative Site of Administration icon begins to
come into the frame and the other icons fade away to the left.
VO: Please note that this process varies by payer and will not be an option if your patient's plan does not
allow for assignment of benefits for a specialty pharmacy under a medical benefit.
SUPER: Alternative Site of Administration (ASA)
VISUAL: The Alternative Site of Administration icon takes center frame. The camera zooms out,
revealing an HCP holding a screen with a map on it. The camera zooms out further to reveal an HCP
showing the screen to a patient. The setting changes and the patient is now at the alternative site of
administration shaking a doctor’s hand. A paper swooshes across the screen. The paper comes to the
center of the frame with the words Benefits Verification across it. The page peels back, revealing a
doctor with a box, a thermometer, and a vial next to them. The doctor turns and moves to the left as a
bill is being inserted into an envelope on the right. The screen is split between the doctor with the bill
and an HCP with a clipboard.
VO: An additional option is utilizing an alternative site of administration, or ASA. This is a facility,
oftentimes an infusion center, that can conduct a patient’s benefit verifications, acquire and administer
the specialty injectable drug, and handle the billing and reimbursement instead of your practice.
VISUAL: The split screen transitions to focus on the HCP in their office. The camera pans around the HCP
revealing their laptop screen. The HCP sits in front of her laptop. Another HCP appears. The laptop
screen displays the ViiV Healthcare logo. The three people and laptop slide to the left and a doctor's
office slides in from the right with patients sitting in a waiting room. The patients sitting in the waiting
room continue to slide to the left.
VO: In summary, learning to navigate the medical benefit is vital to bringing specialty injectable drugs to
your patients. Your ViiV Team is available to support you throughout the entire acquisition process, and
ViiVConnect is available to help further support you and your staff through working with payers if you
choose to utilize the service.
SUPER: ViiVinjectables.com
SUPER: The Access and Acquisition Series
SUPER:
[ViiV Logo]
Trademarks are owned by or licensed to the ViiV Healthcare group of companies.
©2022 ViiV Healthcare or licensor.
CBTVID220015 October 2022 Produced in USA.
VISUAL: The camera zooms in on a person in front of a computer. The woman in front of a computer
comes into the frame. The camera pans around the woman at her desk. The camera continues to pan
around the woman at her desk. The woman is shown at their desk with a patient. Additional individuals
populate around the seated patient. The camera shows a group of patients. A leaf blows past the patient
and the background shifts to an outdoor space revealing a patient walking with his partner and dog. The
camera pans to reveal the ending frame with the words The Access and Acquisition Series.
VO: For more on accessing and acquiring specialty injectable drugs, review the other videos in this
series. And, if you have questions about acquiring specialty injectable drugs covered under the medical
benefit, or how ViiVConnect can support you and your patients in this process, please reach out to your ViiV Team or visit ViiVinjectables.com to learn more
