What is a specialty drug?
What is a Specialty Drug? Manuscript
SUPER: The Access and Acquisition Series: WHAT IS A SPECIALTY DRUG?
VISUAL: A park appears onscreen. A leaf enters the frame. The leaf sweeps across the park to
the right.
VO: The HIV landscape has broadened in recent years to include long-acting specialty drugs.
VISUAL: A healthcare professional's (HCP's) office forms. An HCP works at her desk. The HCP
continues working.
VO: Understanding how to integrate these specialty drugs into your practice can help meet the
ever-changing needs of your patients.
VISUAL: The camera’s view pans past the HCP. The HCP's hand is shown scribbling notes on a
piece of paper. The shot moves past a series of plants. The camera zooms out, showing the HCP
in profile as the words "What is a specialty drug?" appear on screen.
VO: Before discussing how to prepare your practice for accessing these drugs in other videos,
let's first discover what defines a specialty drug.
VISUAL: The HCP and their office space slide off to the left; only the copy remains on the
screen. "Rare, chronic, complex diseases” appears on the screen.
VO: Specialty drugs often treat or prevent rare, chronic, and complex diseases.
VISUAL: "A specialty drug may require specific” appears on the screen, with a hand adjacent.
The hand draws a box to the right of the copy. Copy populates beneath the phrase "A specialty
drug may require specific" as the VO reads the words off. The box opens and a vial lifts out of it.
The vial rotates. The copy continues cycling. The box closes and slides off the screen to the
right.
VO: They differ from traditional medication in that they often have specific storage, handling,
and administration requirements.
VISUAL: The vial appears at the center of the screen. The vial is shown.
VO: Many specialty drugs are injectable medications.
VISUAL: The vial is shown. A hand appears from the bottom of the frame, grabbing the vial. The
camera zooms out, showing an HCP grabbing the vial while her patient sits behind her. The
doctor looks at her patient.
VO: While some are self-administered, other specialty injectable drugs must be administered in
a clinical setting by a healthcare professional.
VISUAL: The view slides right past the doctor and patient, beginning to reveal a container with
boxes inside. The container continues moving into the frame. The container slides out of the
frame to the left as the thermometer slides in from the right. The camera zooms in on the
thermometer.
VO: Some specialty injectable drugs may also require precise temperature control throughout
shipment and storage until it is time to administer them to your patient.
VISUAL: The thermometer slides off to the left as the exterior of a retail pharmacy slides in
from the right. The retail pharmacy holds on the screen. A shopper exits the store with a bag.
The camera slides past the pharmacy, revealing an HCP's office.
VO: Because of these key differences, your patients cannot acquire physician-administered
specialty drugs through a retail pharmacy in the same way they can go and pick up a traditional
oral medication.
VISUAL: The camera holds on the HCP office. The camera zooms in on the window of the HCP
office, revealing a doctor and patient having a conversation. The camera slides to the right of
the window. A sign is revealed. The sign comes into focus, revealing iconography for "specialty
pharmacy" and "specialty distributor."
VO: To acquire a specialty injectable drug, your practice will either coordinate with a specialty
pharmacy or a specialty distributor.
VISUAL: The iconography animates. The sign slides off to the left as papers slide in from the
right.
VO: Your patient's insurance coverage often determines how you will acquire the drug.
VISUAL: The paper checklist and hand come into view.
VO: Acquiring specialty injectable drugs is different from traditional oral medication.
VISUAL: The camera moves out, showing an office manager’s hand using the pen on a piece of
paper. The office manager is shown at their desk with a patient. The Access and Acquisition
Series appears on their screen. The camera zooms out and more patients populate the screen.
The office manager sits facing the patients. The office manager addresses the patients. The
camera travels through the patients and the doors, revealing an outdoor setting.
VO: Yet, as the HIV landscape evolves, understanding specialty injectable drug acquisition is
important so you can continue to support your patients' experience with their prescribed HIV
medications. Contact your ViiV Team or visit ViiVinjectables.com to learn more.
SUPER: ViiVinjectables.com
VISUAL: The camera pans to show people at a picnic. The camera pans to reveal the ending
frame with the words: "THE ACCESS AND ACQUISITION SERIES"
[ViiV Logo]
Trademarks are owned by or licensed to the ViiV Healthcare group of companies.
©2022 ViiV Healthcare or licensor.
CBTVID220013 September 2022 Produced in USA.
VO: And for more on acquiring specialty injectable drugs, continue watching the videos in this series.
Specialty injectable drug coverage options
Specialty Drug Coverage Transcript
SUPER: The Access and Acquisition Series: Specialty injectable drug coverage options
VISUAL: The Access and Acquisition Series: Specialty injectable drug coverage options
VISUAL: A vial appears on the screen with the text "Acquire, handle, and administer. " The vial
remains as the copy "Specialty drugs" slides in. The vial and "specialty drugs" remain.
VO: The way you acquire, handle, and administer specialty drugs can differ from oral
medications available at traditional retail pharmacies.
VISUAL: The hand grabs the vial. The hand holds the vial.
VO: How your patients' insurance covers these drugs also differs. Let's learn about the various
ways payers can cover these specialty injectable drugs.
VISUAL: Icons begin flying in. Icons continue flying in. A piece of paper flies off the clipboard.
The paper and the clipboard remain in the frame. The paper and clipboard remain in place
while a hand and the word “Medicaid” appear on the right.
VO: As you may know, commercial insurance, Medicare, and Medicaid structure their benefits
differently.
VISUAL: The clipboard moves to the back of the screen as the other icons fade away. The paper
comes to the front of the frame, while a hand holding a vial comes in from the left.
VO: This can impact how you acquire these drugs. These payers may cover drugs, services, and
treatments through different benefits. Depending on how your patients’ insurance policies are
written,
VISUAL: The paper and the hand remain, while a gloved hand holding a syringe comes in from
the right. As the paper moves, it flips, revealing “Insurance Policy” written across the top.
Hands appear from the edges of the screen. The hands appear on screen. The paper moves off
the screen, while a doctor comes in from the lower right. "Medical benefit" appears on the
screen. "Pharmacy benefit" appears, shifting "medical benefit" to the left. A plus animates
between the medical and pharmacy benefit iconography.
VO: and whether their drugs are self-administered or administered by a healthcare provider,
their specialty injectable drugs may be covered under a medical benefit, meaning their medical
insurance, a pharmacy benefit, or some combination of the two. A benefit verification will
detail your patient’s specific coverage—and remember, no matter what coverage your patient
has,
VISUAL: A check mark appears above the iconography.
VO: these drugs may require a prior authorization before approval.
VISUAL: The hand sweeps across the screen and sweeps away the iconography. The hand
continues sweeping across the screen, revealing the copy "What does it mean for your
practice?" The hand exits the frame; the text remains. The "medical benefit" iconography
appears with a medical building and doctor. The shot pans to reveal a warehouse. "Specialty
Distributor" appears next to the warehouse as the door opens.
VO: So, what does this all mean for your practice working to acquire a specialty injectable drug?
If the payer covers your patient’s drug under their medical benefit, it may be acquired through
a specialty distributor,
VISUAL: A truck drives out of the open door with the words "Buy & Bill" on it. The truck drives
toward the foreground of the shot. A container forms. The doctor, taking notes, appears to the
right of the container.
VO: via a process commonly known as Buy & Bill. This is when your practice purchases and
stores the drug until you administer it to a patient.
VISUAL: The doctor and container sweep off the screen to the left and a hand holding a vial
swings in from the right. The hand lands center screen and places the vial down as the copy
"pharmacy benefit" appears adjacent to it.
VO: If the payer covers your patient’s drug under their pharmacy benefit,
VISUAL: Vials and a mortar and pestle appear on the screen alongside a call center operator as
the words "specialty pharmacy" populate. The "specialty pharmacy" icon begins moving off the
screen to the left as a paper moves into the shot from the right. The paper is revealed to be a
prescription pad with a doctor's handwriting on it. The hand moves off the screen and a vial
slides out from behind the pad.
VO: it may be acquired through a specialty pharmacy. With a specialty pharmacy, a prescription
is written for that patient and the drug is sent to your practice
VISUAL: The paper continues moving around the vial. The vial and prescription paper fall into
the bag. The vial and prescription paper enter the bag. The bag’s top is closed. “White Bagging”
copy appears.
VO: when it is nearing the time of administration. This is also called "white-bagging."
VISUAL: The shot pans out to reveal the doctor holding the bag. The doctor and a medical
building appear on screen. The "medical benefit" and "specialty pharmacy" iconography
appear, with an unidentified link shown between them. The unidentified link is populated with
“assignment of benefits (AOB)” iconography.
VO: If your patient’s insurance covers the drug under the medical benefit, but you and your
practice would prefer working with a specialty pharmacy instead of a specialty distributor, your
practice may have the option to acquire the drug through an Assignment of Benefits, or AOB.
VISUAL: The screen splits, revealing a call center operator and a health care professional (HCP)
on the phone. The split screen collapses, leaving the HCP onscreen. A door appears.
VO: You will determine if working with a specialty pharmacy is possible given your patient's
coverage.
VISUAL: The doctor begins speaking to a patient. The shot continues moving; the doctor and
patient move off the screen to the left. An office manager at her desk begins appearing from
the window.
VO: Please note that this process varies by payer and will not be an option in all cases. As you
can see, specialty injectable drugs are covered differently and may require adopting a new
process in your practice.
VISUAL: A patient is shown sitting across from the office manager. More patients populate
behind the seated patient. Camera pans right to show more patients onscreen. More patients
are revealed as the camera continues to pan right. Camera zooms in through doors, revealing a
park where various activities are taking place.
VO: To help more people access HIV medications, assistance from ViiVConnect is available.
ViiVConnect is committed to helping inform healthcare providers about the options available
for acquiring ViiV medicines so you can continue to support your appropriate patients. Contact
your ViiV Team or visit ViiVinjectables.com to learn more.
SUPER: ViiVinjectables.com
VISUAL: Camera continues to pan to reveal people taking part in various activities, like walking
a dog.
VO: Be sure to watch other videos within the ViiV Access and Acquisition series to learn more
about working with specialty distributors and specialty pharmacies.
VISUAL: The camera pans to reveal the final frame, which says: The Access and Acquisition
Series
[ViiV Logo]
Trademarks are owned by or licensed to the ViiV Healthcare group of companies.
©2022 ViiV Healthcare or licensor.
CBTVID220014 September 2022 Produced in USA
Specialty pharmacy acquisition process
Specialty Pharmacy Manuscript
SUPER: The Access and Acquisition Series: Specialty pharmacy acquisition process
SUPER: Specialty Drugs
VISUAL: A park appears with a person walking through it. A leaf floats off to the right. The leaf moves across the screen. "Specialty Drugs" appears on the screen along with a vial. An HCP sits at their desk with a patient across from them. The text "Specialty Drugs" and vial continue floating above the HCP and patient.
VO: Accessing specialty drugs may be a new experience for your practice, but learning to integrate these drugs can provide additional options for your patients.
SUPER: Differs from traditional oral medication
SUPER: Insurance Coverage
VISUAL: The HCP walks out of their office toward a filing cabinet. The HCP reviews a paper from the filing cabinet. The HCP continues reviewing the paper. “Pharmacy Benefit” appears on the screen.
VO: The way your practice acquires specialty injectable drugs differs from traditional oral medication. This acquisition method is highly dependent on your patient’s insurance coverage. Let’s discuss the details of acquiring a specialty injectable drug when the patient’s insurance covers it under the pharmacy benefit.
SUPER: Pharmacy Benefit
VISUAL: The HCP and text slide down off the screen. The specialty pharmacist appears with a paper that reads “Specialty Pharmacy.”
VO: When covered under a patient's pharmacy benefit, you will acquire the drug through a specialty pharmacy.
SUPER: Specialty Pharmacy A Specialty Pharmacy is not a standard "walk-in" retail pharmacy. They:
- Help coordinate several aspects of patient care
- Deliver medications with special handling, storage, and distribution requirements
VISUAL: The “Specialty Pharmacy” definition begins animating in. The definition and icon remain on the screen.
VO: A specialty pharmacy is not a standard "walk-in" retail pharmacy. They coordinate several aspects of patient care and deliver medications with special handling, storage, and distribution requirements.
SUPER: Benefit Verification The process of verifying the patient’s current medical coverage with the insurance company.
VISUAL: The HCP appears onscreen from the right as the paper flies off. The paper reappears from the top of the screen. “Benefit Verification” animates onto the paper. The HCP rotates as the Benefit Verification definition animates in. The clipboard grows closer as the pages are rifled through. A page of the clipboard reveals a checkbox with the word "Coverage" next to it. The pages of the clipboard return back down.
VO: Once an appropriate patient is identified for the prescription of a specialty injectable, your practice will conduct a benefit verification to confirm your patient’s coverage and detail any prior authorization requirements. Please remember that prior authorizations are rather common for these drugs.
VISUAL: The clipboard and definition move off the screen to the left as a specialty pharmacy storefront slides in from the right. The specialty pharmacy centers on the screen. The camera zooms out as additional specialty pharmacy storefronts appear. The storefronts line up across the screen. Various storefronts are highlighted. The storefronts remain. The shot pans out to reveal the specialty pharmacy character. The highlighted storefronts rise. The man circles the selected storefronts. The man and storefronts remain.
VO: Once the patient’s insurer confirms that the drug is covered under the pharmacy benefit, your practice should inquire about which specialty pharmacies are in-network with the patient’s insurance, and then select the ones your practice would like to work with. Remember that the choice of pharmacy is sometimes dictated by the patient's insurance and the availability of the drug.
SUPER: Prior Authorization
The approval from a health plan that may be required before a patient receives a service or a therapy.
VISUAL: The person slides off the screen to the right, along with all but one specialty pharmacy storefront. An HCP begins appearing from the left. The HCP comes fully into the frame with the specialty pharmacy storefront. A piece of paper from the HCP flies off toward the specialty pharmacy. A paper with a patient photo appears on the left of the storefront. Checkboxes populate below the patient photo. The patient photo disappears as “Prior Authorization” replaces it. The Prior Authorization definition appears along with a checkbox with the word “Approved” below it. The shot pans in on the specialty pharmacy, the definition disappearing behind it. The camera continues panning in on the pharmacy. The shot pans into the pharmacy, revealing a technician on the phone at a desk. An exclamation mark is revealed to emphasize importance.
VO: Your ViiV Team can supply you with a list of specialty pharmacies to work with. Once verified, you can send a prescription to the specialty pharmacy for the drug. They may require additional details, like information regarding the patient's diagnosis. The specialty pharmacy will confirm any outstanding items, including whether a prior authorization is needed, and coordinate a shipment date for the drug so it arrives around the time of the patient’s injection appointment. The specialty pharmacy may contact the patient to obtain permission to bill their insurance company, discuss co-payment or other financial responsibilities, as well as gain their consent to ship the medication.
VISUAL: The shot reveals a staff member in the specialty pharmacy from the right, opening a package. The staff member picks up the phone. The patient is shown receiving the call on the right. The pharmacy tech slides off the screen.
VO: It is very important that the patient answers any communications from the specialty pharmacy to ensure their shipment isn’t delayed. The specialty pharmacy will then ship the drug
SUPER: White Bagging
An arrangement between payers and specialty pharmacies to ship a patient’s medication directly to the physician’s office.
VISUAL: The pharmacy tech and patient move off the screen as a box and the "white bagging" definition slide in from the top. A physician's office facade slides in from the right. The box begins moving into the physician's office. The box enters the office through the doors. A staff member receives the box. The staff member receives the box and verifies the information on it. The staff member holds the box. The camera rotates around the staff member. The staff member places the box in a container. The container moves across the screen to the left as an HCP enters from the right. The container moves off the screen to the left as a calendar appears to the right of the HCP. The HCP and calendar move off the screen to the left.
VO: to your practice, commonly referred to as “white bagging.” Keep in mind that specialty injectable drugs obtained through a specialty pharmacy are for a specific patient and should not be administered to other patients. Once received, be sure to store and handle the drug as required, and finally administer the injection at the patient’s scheduled appointment.
VISUAL: An office is shown, with papers flying into an envelope on top of a desk. The shot pans in on the papers sliding into the envelope. A stamp appears on the desk. A hand presses the stamp onto the envelope. The stamp is removed, revealing the “specialty pharmacy” icon. The envelope remains in the shot. The “specialty pharmacy” icon remains on the screen.
VO: Unlike medications acquired under buy-and-bill, when submitting claims for specialty pharmacy-acquired drugs, you may be able to bill for administration, but not the cost of the drug. Billing for the specialty drug is handled by the specialty pharmacy, so your patient will pay any drug-related co-pays or coinsurance directly to the specialty pharmacy.
VISUAL: The “specialty pharmacy” icon remains on the screen. The "specialty pharmacy" icon remains center screen. The "specialty distributor" icon joins, moving the "specialty pharmacy" icon to the left. The icons begin moving off the screen to the right.
VO: Please note that not all patients’ insurers will cover acquisition through the pharmacy benefit and specialty pharmacy, so it is important to understand the different types of acquisition methods available.
VISUAL: A doctor’s office waiting room is revealed, showing patients sitting in chairs. The seated patients continue moving across the screen to the left. The shot pans in on a seated patient. The shot further tightens on the patient. Leaves begin flying by the patient.
VO: Remember, your ViiV Team is available to support you throughout the entire acquisition process, and ViiVConnect is here for your practice—and most importantly your patients—regarding appropriate access, if you choose to utilize the service.
SUPER: ViiVinjectables.com
SUPER: The Access and Acquisition Series
VISUAL: The shot pans out, revealing people having a picnic outside. The shot continues panning out, revealing a person biking by. "The Access and Acquisition Series" appears onscreen and then swipes away, fading to white.
VO: Contact your ViiV Team or visit ViiVinjectables.com to learn more. For more on accessing and acquiring specialty injectable drugs, review the other videos in this series.
VISUAL:
[ViiV Logo]
Trademarks are owned by or licensed to the ViiV Healthcare group of companies.
©2022 ViiV Healthcare or licensor.
CBTVID220016 October 2022 Produced in USA.
Buy & Bill acquisition process
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
Real People. Real Experiences.
See real people talk about their experiences with PrEP
Mason
A real patient on oral PrEP who struggles taking pills every day.
Michael
A real patient on oral PrEP who has missed daily doses.
Alejandro
A real patient who is considering a switch from oral PrEP to APRETUDE.
Angelique
A real patient on oral PrEP who sometimes forgets to take her daily pill.
Zach
A real patient formerly on APRETUDE, which is not offered by his new doctor.
