Oncology Management Programs

CareCore Oncology offers robust product offerings that deliver cost-effective utilization management of oncology drugs and injectables.

OncoSupport™

With over 900 biotech and oncology products in the pharmaceutical pipeline, timely management, tracking and appropriate reimbursement of these costly and unclassified drugs becomes essential to controlling this rising cost segment.

Detailed claims processing support for recently launched and unclassified injectable drug identification,
reimbursement and trend management:

• OncoSupport™ provides NDC unit reimbursement methodology for all unclassified injectable drugs
• Reimbursement updates provided within 10 days of newly launched drugs availability
• Identification codes are attached to the claims for reporting/tracking/auditing purposes
• Toll-free OncoSupport™ Line provided for claims staff management support

OncoAudit

• Injectable drug specific reimbursement auditing to ensure payment compliance
• Site of injectable drug administration auditing to track facility based migration
• Injectable drug trending to monitor high cost injectable utilization
• Program specific auditing to measure cost savings and utilization impact
• Available quarterly or bi-annually

OncoNETWORK™

Recognizing the need to focus on the specialists administering costly injectable and oncology agents, the OncoNETWORK™ Assistance Program assists in the identification, measurement and accreditation of qualified specialists administering these products.

The OncoNETWORK™ Assistance Program supports a health plan’s current oncology network by surveying network providers. Through the application of quality-based practice standards and appropriate incentives, it identifies, ranks, inspects and accredits qualifying practices. This process works with network/provider management staff to ensure high-cost drugs are administered to members in a safe and appropriate environment.