Editor’s Note: Augusta Oncology, now known as AO Multispecialty Clinic, is a physician-owned multi-specialty practice with four locations and 28 providers specializing in medical oncology, hematology, rheumatology, urology, and more. Since 2021, the organization has partnered with TailorMed to optimize its financial assistance program. We sat down with longtime financial navigator Christina Armbruster to discuss her important role—and the benefits of a proactive, tech-supported approach to assistance.
TailorMed: Tell us a bit about your professional background and what motivated you to become a financial navigator.
Christina Armbruster: I worked in primary care for four years, where I became the patient intake department lead. I was then offered a position here at Augusta Oncology working as a medical assistant. Once I felt I had mastered that role, I moved into prior authorization, which is how I gained my knowledge of billing. It satisfied the part of me that wanted to learn more of the patient journey.
I then expressed interest in our Patient Account Representative role. The more generalized term is “financial navigator.” All the knowledge I had gained from working in the lab and prior auth field helped me build a great foundation. Treatment may have clinical side effects, but there’s this whole other monster that comes with billing and insurance coverage. I made it my personal goal to understand everything I could about how to find a resource for someone. That’s where I found my niche.
TailorMed: You’ve been at Augusta Oncology (now AO Multispecialty Clinic) for over 11 years. What are the main responsibilities of your role?
CA: For our four offices, I do the filing, tracking, and recoupment of all financial assistance claims for injectable and infused drugs. Our Patient Account Representatives review the patient’s insurance coverage and set them up with their funds. The next process is, of course, filing the claims. But somebody needs to get the money back and make certain it’s applied to the patient’s account, so that the full benefits are maximized. That’s my role.
If I’m in a patient’s account and I see funding is dwindling, I notify our reps of other upcoming funds. I can see exactly where the money’s being left; if there is a better utilization that allows the patient and our practice to get a higher benefit, I offer that advice.
TailorMed: What are the greatest challenges of your work?
CA: One of the largest challenges facing financial navigators is the uptick in enrollments for Medicare Advantage policies. These plans will pay a certain percentage, but the patient is left with a percentage up to their out-of-pocket maximum. Every year, those maximums have increased by thousands of dollars. More people have higher costs, and there is not as much assistance to spread around. The plans have low premiums—and a lot of times the patient can’t afford traditional Medicare supplements—so it’s a Catch-22. We’re trying to solve a problem, not just with treatment costs but having to explain the patient’s insurance benefits to them.
With my workflow, the most challenging aspect is that each pharmaceutical company has a copay card for their products. Today, we have brand name drugs and biosimilars. Well, each one of those has a copay card, and for each drug or manufacturer, they have their own method of filing and paying claims. Most have online submissions, but because of the volume and the different rules, it’s easy to overlook something or have a delay in payment.
This is a challenging and very necessary role. I think that’s become more apparent as costs have steered towards the patient’s responsibility.
TailorMed: What are your greatest rewards?
CA: When somebody receives a serious diagnosis, they’re focused on their physical health, and rightfully so. I enjoy being able to help someone who may not have thought about the cost aspect. Or maybe they have, and it’s caused them a lot of stress or anxiety until they meet with our team. We can reassure them that they do have coverage, even if they are going to have some responsibility. We’re here to help them with the costs, whereas the clinical team is going to help with their physical care. But the emotional and financial burden greatly contributes to the patient’s overall health. And I personally enjoy helping with a lesser-known issue that has such a massive impact.
TailorMed: With the costs of cancer care on the rise, what types of financial struggles have you observed among patients?
CA: Because of the recession and high prices, we often see multiple generations living in the same household. Sometimes, this can prevent patients from being eligible for certain services like Medicaid, because everybody’s household income and assets are combined.
We’ve all had conversations with patients who have either received a bill or are starting treatment. They want to know right off the bat, “How much is this going to cost me? Because I’m not leaving my family in debt if something happens to me.” Many patients say they would not elect to receive treatment if there were no way for a portion of their bill to be resolved. We have seen patients having to pick and choose each month whether they’re paying for groceries or medicine. Some don’t have funding to get to the various treatment appointments.
There have also been patients who want to proceed with their current treatment, but they’re looking for less expensive options which may not give them the best life-prolonging outcome.
TailorMed: How has AO Multispecialty committed to removing financial barriers to care?
CA: For the past 11 years since I’ve been here, we have always had a financial navigation program. I give credit to our administration for seeing that need a long time ago. Our leadership has been dedicated to keeping the department alive, understanding that it is a standalone workflow. That commitment enables our team to successfully use a technology solution like TailorMed and to continue helping regardless of what specialty the company acquires. We’ve paved the way and made it easier for ourselves because we know the assistance programs like the backs of our hands.
TailorMed: What were some of the challenges your team encountered that motivated your leadership to consider a technological solution and why did your organization choose TailorMed?
CA: The manual nature of our processes was a big factor. We kept logbooks with names of patients and disease types for which we needed X amount of funding. That way, when a relevant fund opened—so long as you were sitting at your desk and you got the email, or you just happened to be on the website—you could jump on it. These systems lengthened our processes and prevented us from capturing all available funding.
We were also seeing an increasing patient volume—more than twofold for each one of us. We knew our organization was acquiring more physicians and expanding to another building. So, we started using TailorMed at the best time, based on our growth. It just fit the pocket and allowed us to take off, without placing any kind of burden on us.
TailorMed: Augusta went live with TailorMed’s platform in January 2021. What were some of your team’s goals and how has TailorMed helped you achieve them?
CA: We wanted to reach more patients in less time and maximize the assistance we could secure. With TailorMed pulling information from our medical record system and billing department, our team no longer has to go to each one of those systems. Now, we have one place where we can see diagnosis, financial responsibility, insurance coverage, and available funding. Already, you’ve shaved off at least 15-20 minutes just trying to cross-reference.
It has also helped make the information readily available between each navigator, so that we all know exactly who has assistance, who needs it, who may require it. A couple of us work in the same building, but the navigators who meet one-on-one with patients are each at a different site. Now, when a fund opens, we can capture assistance for each other’s patients.
TailorMed: What advice would you give to other healthcare professionals who are looking to optimize financial assistance with the help of technology?
CA: If their leadership had any uncertainties about whether this was a need, I would ask them to really consider implementing a technology solution. I say this because not many employees within a healthcare organization understand a navigator’s workflow. You might need to advocate and build the business case.
TailorMed has been absolutely fabulous to work with. They care about their clients, and they’re willing to ensure their products are understood and fully utilized. The ability to customize features is fantastic, and the filters are endless. The timely response on support tickets is second to none. Being on a first name basis with everyone I’ve come in contact with creates another layer of confidence. When we ask questions, we know we’ll get an accurate, professional response.
It’s important that your team enjoys using the platform you choose, because they’ll be more likely to use it. And the more it’s used, the easier it becomes—which improves the team’s ability to reach more people and secure more assistance. It all comes back to the patients and our ability to help them.
To learn more about how we partnered with AO Multispecialty to double assistance program enrollments and revenue, read our case study.
