Understanding Patient Confusion to Resolve Financial Assistance Pain Points

A biopharmaceutical company wanted to gain more context around changing reimbursement requirements associated with certain therapies. They wanted to know what was driving their patients to call and if their agents were equipped to answer the variety of questions being asked. 

Authenticx in Action  

Initially, Authenticx evaluated 200 interactions within a 60-day period. Quickly, Authenticx discovered that patients were calling in response to a perceived enrollment into a new insurance plan that stopped the copay support they had been receiving for their medication through the biopharmaceutical company. This might look like: 

“I went into the pharmacy to pick up my medication and expected to only pay $10 like I had been, and now they are saying I owe over $1,000.”

“This came out of nowhere. I paid only $5 with my copay last month and now I can’t afford to pay what they are saying I owe from this new plan.”

“My card isn’t working at the pharmacy anymore and I don’t know why. “

Through these calls, we found that 37% of the callers expressed confusion about the denial of their copay card (due to the changing copay card restrictions), while nearly 19% developed frustration over the program’s complications (including lack of communication from their payers about their enrollment into a new program). Authenticx found that the language around this change was complex and misunderstood by both the patients and the agents.  

Out of the 200 interactions, approximately 80% experienced a potential detractor during the call experience. Detractors are the specific reasons customers or patients feel unhappy with a brand or that their needs have been unmet, which conversely impacts their overall experience. After this initial phase, Authenticx continued to analyze calls for an additional 30-day period. The company wanted to understand more patient scenarios, listen to the agents’ responses, and uncover how to optimize the experience.  


After these contextual insights were aggregated and shared with the company (with Montage Builder), the company asked their teams to create a plan for action to decrease the detractor rate and optimize the caller experience. The teams have worked to create more specific training for agents so that they can provide clear direction and answers for their patients. Authenticx continues to monitor and track these calls, measuring decrease in detractors and negative emotions present on the initial calls.

To date, both have decreased significantly, brand detractors by just under 50%, and confusion caused by agents decreased by 10%.  

If the biopharmaceutical company didn’t utilize Authenticx to listen to the conversational data, then they wouldn’t have received actionable insights about how the changes to their reimbursement program requirements affected the cycle of feedback from patient to pharmacy to agent for a direct solution. 

Authenticx in Action | On-Demand Video

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About Authenticx

Authenticx was founded to analyze and activate customer interaction data at scale. Why? We wanted to reveal transformational opportunities in healthcare. We are on a mission to help humans understand humans. With a combined 100+ years of leadership experience in pharma, payer, and healthcare organizations, we know first-hand the challenges and opportunities that our clients face because we’ve been in your shoes.

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