Speeding Up Specialty Care

At BioPlus Specialty Pharmacy, Claire Heins has driven an ethical approach to delivering faster, more seamless medical solutions

Claire Heins, vice president of revenue cycle management at BioPlus Specialty Pharmacy, first started with the company twenty-seven years ago as a receptionist. Over the decades, she’s grown hand in hand with the company, as both it and the specialty pharmacy industry have expanded. “Although I inadvertently ended up in the specialty pharmacy industry, I was lucky enough to find the perfect match with BioPlus, which allows me to bring an ethical approach to my work with people who share a passion for excellence,” Heins says.

As a pharmacy group that specializes in medical specialties ranging from hepatitis C and Crohn’s disease to dermatology and multiple sclerosis—and, more recently, oncology—BioPlus’s patients often have needs for immediate treatment as well as varied medical plans that can be complex to navigate. One of the things that Heins appreciates most about the company, she says, is how much it focuses on partnerships with physicians and patients to ensure optimal outcomes for the patient’s health. A major solution that they’ve created and are known for in the industry is their Two-Hour Patient Acceptance Guarantee—a promise that BioPlus will conduct a full benefits investigation and inform physicians within two hours whether they will be able to service a patient.

This guarantee emerged from discussions in 2013 that BioPlus team members had with physicians about what areas of delay were frustrating for physicians and their patients. “Previously, patients could wait days or even weeks to find out if a particular specialty pharmacy could accept them for treatment,” Heins says. “With our guarantee, this first step to starting treatment is completed in just two hours.” She notes that for patients whose treatment is particularly time-sensitive—such as oncology patients, for whom delays in starting medication could be life-threatening—having this immediate timeline can be vital to prompt treatment.

Claire Heins, VP of Revenue Cycle Management at BioPlus

To supplement their commitment to patient care even further, BioPlus also released a new app this past May: RxCommunicator. This app provides physicians with a secure and instant interface to monitor each patient’s admission journey, including the status of the two-hour guarantee. In the event of a slower result, BioPlus makes a donation to patient-assistance foundations, while a smaller donation is also made for every referral meeting the guarantee.

Working on the back end, Heins’s team also monitors results from the front end to make sure that there aren’t any issues, an approach that they refer to as circular training. “By having a peek at every other department, my team sometimes catches small errors, which we embrace as a learning opportunity—both fixing the immediate problem and setting up trainings to make the company stronger in future work,” Heins says, adding that this honest and open process helps make each team successful, which in turn lifts up the whole company.

This circular training ties into the company’s founding model, known as CART: Competence, Accountability, Respect, and Trust. “From the outset, we had a different mind-set than other companies,” Heins says. The company’s core values are consistent across departments, from the open-door policy of management teams to keeping the workplace free from gossip in order to create a respectful environment and a culture of trust. “When patients see us demonstrate the qualities of reliability and trustworthiness in every interaction, they know they can count on us in what might be the most difficult health challenge of their lives,” Heins says. In fact, BioPlus views errors as an opportunity to fix something and prevent a recurrence in the future, something that they refer to as “failing forward.”

“When patients see us demonstrate the qualities of reliability and trustworthiness in every interaction, they know they can count on us in what might be the most difficult health challenge of their lives.”

This leadership approach has paid dividends, as BioPlus recently expanded both their hepatitis C and oncology presence. “With these diseases, patients are literally fighting for their lives,” Heins says. With stakes this high, BioPlus supports patients by helping them navigate complex insurance issues and connect with foundations that provide financial assistance. These efforts have not gone unnoticed, with BioPlus recently ranking as number one in oncology among specialty pharmacies by a Zitter Health Insights survey and the Accreditation Commission for Health Care Inc. approving BioPlus for accreditation for Specialty Pharmacy with a Distinction in Oncology in 2016.

As one of the longest-serving members of BioPlus, Heins continually works to grow with them on every level. In 2010, she went back to school to get her BS in business management, learning more about ways to enhance her work within the company. This dovetailed with new responsibilities, including helping lead the accreditation team and working with compliance.

For Heins, it all comes down to doing the right thing for patients and physicians. A recent incident highlights this: a cancer patient contacted BioPlus, alarmed that they had inadvertently spilled water on their medication, destroying four pills of a high-cost and yet essential oncology medication. After unsuccessfully trying to replace the medication through the manufacturer and a patient foundation, BioPlus stepped up and sent out replacement pills at a company loss of eight hundred dollars. “For me, this is what it means to work at an ethical company that does the right thing for patients, regardless of profit,” Heins says. It’s why she’s stayed with the company for her entire career and continues to grow with both the company and the industry.