Patient Support Services - Workflow scenario
Summarize
Summary of Patient Support Services - Workflow scenario
The Patient Support Services application streamlines enrollment activities for patient support programs, including onboarding and pre-authorization. It enables healthcare providers and care coordinators to manage patient enrollment, verify eligibility, coordinate with insurance and pharmacies, and facilitate additional support services such as savings cards and injection training. Starting with the Yokohama release, this application is being prepared for future deprecation; it will be hidden on new instances but remains supported for existing customers.
Show less
Workflow and User Roles
- A doctor prescribes medication and informs the patient about the patient support program and savings card offered by a pharmaceutical company.
- The patient submits an enrollment application with personal, insurance details, and service requests (e.g., savings card, sharps disposal, injection training), including HIPAA consent.
- Upon application submission, an enrollment case is created in ServiceNow, triggering the Patient Support Services workflow and assigning the case to a care coordinator (e.g., John).
- John uses the Workspace to review patient information, verify details, and access a playbook that guides him through enrollment steps with full process visibility.
- John validates the application and accepts enrollment if eligibility criteria are met, triggering a welcome email to the patient.
- John coordinates benefit investigation with insurance or specialty pharmacy as needed.
- After benefit investigation completion, the workflow triggers fulfillment tasks for enrolled services (e.g., sending savings card, sharps disposal containers) and sends an email for the patient to book injection training.
- John places the prescription order with the pharmacy, confirms delivery, and notifies the patient.
- The patient books injection training via the patient portal, assigning a training task to the Nurse Training Support group.
- A nurse educator conducts the injection training and completes the training checklist in Workspace.
- The enrollment case is closed when all associated tasks are completed.
Practical Benefits for ServiceNow Customers
- Enables efficient management of patient support program enrollment within ServiceNow.
- Provides care coordinators with a structured playbook for consistent and transparent case handling.
- Facilitates coordination with insurance companies, pharmacies, and nursing staff directly through the workflow.
- Improves patient experience by automating notifications and scheduling support services.
- Ensures compliance with HIPAA consent capture during enrollment.
- Supports task tracking and case closure based on completion of all required patient support activities.
Use the Patient Support Services application for streamlining enrollment activities for a patient support service including patient onboarding and pre-authorization.
Starting with the Yokohama release, Patient Support Services is being prepared for future deprecation. It will be hidden and no longer activated on new instances but will continue to be supported.
For details, see the Deprecation Process [KB0867184] article in the Now Support knowledge base.
Scenario: A doctor prescribes some medicines and injections to treat a disease diagnosed in a patient. The patient is concerned about the cost because of a high co-pay medical insurance plan and is worried about taking injections by oneself. The doctor tells the patient about the savings card and patient support program offered by a pharma company. The doctor then helps the patient to submit the enrollment application. In the enrollment application form, the patient enters all personal and insurance details and requests support for the savings card, sharps disposal service, and injection training. The patient signs the Health Insurance Portability and Accountability Act (HIPAA) consent and submits the enrollment application form. When an enrollment case is created in the ServiceNow instance, the Patient Support Services workflow initiates a playbook configured for enrollment cases. The case gets assigned to John who is a care coordinator.
The following graphic shows how the Patient Support Services application is used for managing the patient support program as discussed in the scenario.
The following workflow elaborates how various users use the Patient Support Services application to enable the patient to enroll for a patient support program and obtain the savings card from a pharma company:
- John uses the Workspace to view the enrollment case.
- In Workspace, John can view complete information about the patient from the
Patient information tab.
John validates the patient details including insurance on file, contact information, and medical history.
- John then selects the Playbook tab to view all the necessary
case-related information.
The layout of a playbook enables care coordinators to focus on the steps they are responsible for, while providing full visibility into the end-to-end process life cycle.
- John reviews the application, verifies the prescription and consent, and accepts the enrollment application after reviewing that the patient meets the eligibility criteria of the program.
- The patient is enrolled into the patient support program and a welcome email notification is sent to the patient.
- Based on the patient's preference, John either works with the insurance company or coordinates with the specialty pharmacy to complete the benefit investigation activities.
- After the benefit investigation activities are set to complete, the Patient Support Services workflow:
- Triggers the fulfillment tasks for each service that the patient has enrolled into. In this example, tasks are created for sending a savings card and sharps disposal container.
- Sends an email notification to the patient to book the appointment for the injection training support.
- John contacts the pharmacy to place the prescription order through fax or email, confirms the drug delivery date with the pharmacy, and sends a confirmation email to the patient.
- The Patient books the appointment for the injection training from the patient portal, and then a training task is assigned to the Nurse Training Support assignment group.
- A nurse educator from the Nurse Training Support assignment group provides the injection training to the patient and completes the training checklist in Workspace.
- The enrollment case is set to complete when all the enrollment tasks are set to complete in the playbook.