Streamlining Care in Own Office: A Practical Guide to Navigating New Biologics
Apr 1, 2025
Streamlining Care in Your Own Office: A Practical Guide to Navigating New Biologics and Insurance Changes
By Brianna Pepin
Biologic Coordinators (BCs) are the unsung heroes of specialty care, working behind the scenes to ensure patients receive timely access to life-changing therapies. As the landscape of specialty medications evolves—especially with the introduction of new biologics and shifting insurance requirements—it’s more important than ever for staff to understand the BC role and how it integrates into daily workflow.
This guide breaks down how to explain the BC role, onboard your team, and keep your office ahead of the curve.
Start with an Overview of the Role
When introducing your position to the team, start with a simple elevator pitch:
“I manage the coordination of biologic therapies for our patients, ensuring they have seamless access to the medications they need. This includes managing logistics, patient education, and compliance with all necessary protocols.”
Highlight Key Responsibilities
Understanding the scope of your work helps your colleagues see where you fit in the care continuum.
Patient Support
“I serve as a resource for patients prescribed biologics. I help them understand how their therapy works, what side effects to expect, and how to self-administer injectable medications.”
Insurance Navigation
“I handle prior authorizations, appeals, and communicate with payers to secure coverage. This minimizes delays and eases the burden on the clinical team.”
Scheduling & Communication
“I coordinate infusion appointments or injections, and work with infusion centers, specialty pharmacies, and home health services to keep everything running smoothly.”
Inventory Management
“For offices that carry in-house biologics, I track inventory, manage storage, and make sure we meet all safety standards.”
Monitoring Compliance
“I follow up with patients to ensure they’re adhering to treatment and troubleshoot any issues that may affect outcomes.”
Emphasize the Impact
Biologic Coordinators are a vital link between the provider, the patient, and the payer.
“My role bridges the gap between clinical care and logistical challenges. By streamlining these processes, I help ensure patients get the treatments they need, when they need them, with fewer barriers. That means better outcomes and less stress for everyone involved.”
Share Day-in-the-Life Examples
Paint a relatable picture of your role:
“In one day, I might help a patient navigate a denied authorization, coordinate an infusion at an outside facility, and educate another patient on their first self-injection. Every step is about smoothing the patient journey.”
Encourage Team Collaboration
“I work closely with nurses, providers, and administrative staff. If you have questions about biologic therapy or the insurance process, don’t hesitate to reach out—we’re all here to support each other.”
Talking to Staff About New Biologics and Insurance Changes
Keeping your team informed about medication and policy updates improves patient access and helps prevent delays.
Start with the Purpose
“I want to keep you in the loop on new biologics and insurance updates so we can work together efficiently. These changes impact how we prescribe, coordinate, and administer treatments.”
Discuss New Biologics
Introduction of the Therapy
“A new biologic, [Name], has been approved for [condition]. It stands out due to **[key benefit like reduced dosing frequency or novel mechanism].”
Prescribing Info
Indications: [Conditions treated]
Administration: [Injection, infusion, etc.]
Common Side Effects: [Overview]
Patient Education: [What patients should know]
Workflow Impact
“This may change how we schedule, monitor, or store medications. Let’s work together on any process changes needed.”
Explain Insurance Updates
Policy Changes
New or revised prior authorization requirements
Step therapy mandates
Adjusted coverage criteria or copay programs
How It Affects Us
“These changes might mean more documentation or extra steps. Catching them early helps us avoid delays in treatment.”
Share Solutions and Resources
Streamlining Processes
“I’ll create cheat sheets or templates for new PA forms and stay in close contact with insurance reps to clarify requirements.”
Patient Assistance Programs
“I’ll keep track of manufacturer copay and free medication programs to help eligible patients get the meds they need.”
Training Opportunities
“I can set up short in-services for anyone interested in learning more about new therapies or payer processes.”
Foster Collaboration and Invite Feedback
“Let’s make this a team effort. If you run into recurring issues—like denied PAs or patient concerns—bring them to me. Together, we can find solutions and improve the experience for our patients.”
Final Thoughts
Navigating the world of biologics and insurance changes isn’t just about paperwork—it’s about making sure patients receive the care they deserve. By clearly defining your role, sharing timely updates, and encouraging collaboration, you can transform complex workflows into streamlined systems that benefit the entire office.
And most importantly—you’re not alone. We're all here to support each other in delivering exceptional care.
_____________________________________________________________________
💡 Want more dermatology and patient access insights? Subscribe to the BC Insider Newsletter for expert tips and resources! 🚀
At BC Educators, we are dedicated to empowering biologic coordinators, healthcare professionals, and patient advocates with the education, tools, and resources needed to optimize patient care. From expert-led webinars to hands-on training, we provide comprehensive support to help you navigate the ever-evolving landscape of specialty medications and prior authorizations.