Every dose carries major financial risk
High-cost buy & bill drugs for NMIBC require practices to acquire therapy before reimbursement. A missed authorization or coverage issue can turn a single dose into a substantial loss.
Clear the path for NMIBC treatment and protect every high-cost dose.
Avico automates benefits checks, prior authorization, reauthorization, and patient cost estimates for high-cost NMIBC therapies, helping urology practices protect revenue and keep patients on treatment.
Book a DemoThe Challenges
High-cost treatment, changing rules, long courses
Urology practices carry substantial financial exposure when administering high-cost buy & bill drugs for NMIBC. At the same time, staff must navigate plan-specific requirements and keep every authorization aligned across a long course of treatment.
The approval path changes by plan
Prior authorization, medical-necessity, and step-therapy requirements can differ across Medicare, Medicare Advantage, and commercial plans. Staff must determine the right path for each patient and therapy.
Friction puts long treatment courses at risk
NMIBC treatment can extend across many doses and months. Reauthorizations, coverage changes, and patient cost uncertainty can lead to delays or drop-off before the course is complete.
Our Solution
One clear path from coverage to care
Avico's AI agents execute the payor and financial work required around each dose, from verifying coverage and securing approval to calculating patient responsibility.
Confirm coverage before each dose
Avico verifies active coverage, authorization dates, plan limits, and buy-and-bill versus specialty pharmacy routing before treatment.
Build the right case for the plan
Avico checks current payor requirements, pairs the diagnosis and treatment history with the right chart evidence, submits through the required channel, and tracks the case to determination.
Resolve patient cost uncertainty sooner
Avico calculates expected patient responsibility and flags patients who may qualify for financial support before cost concerns interrupt treatment.
Treatment Access
One workflow across NMIBC therapies and payor rules
Avico checks the patient's current coverage and the applicable policy for the prescribed treatment. Requirements can change, so each case is evaluated against the relevant plan rather than a universal rule.
High-cost NMIBC treatment access
For therapies such as Anktiva, Adstiladrin, and Inlexzo, Avico applies the patient's current plan requirements to the prescribed treatment and submits the prior authorization before the scheduled dose.
Medicare and commercial plan requirements
Avico checks the applicable Medicare, Medicare Advantage, or commercial policy rather than relying on a universal rule. Requirements can vary by patient, plan, indication, and policy date.
Reauthorization across long courses
Avico monitors authorization windows and rechecks coverage as treatment continues, helping the practice address expiring approvals and plan changes before they disrupt the course.
Denial prevention and documentation
Avico catches missing chart evidence, unmet step edits, and submission issues before the request goes out, then keeps authorization and reference details available if the practice needs to challenge a denial.
Impact
Protect revenue and help patients stay the course
Urology practices carry the financial risk for high-cost NMIBC therapies. Avico's AI agents complete routine payor work before treatment, helping teams prevent missed authorizations, avoid unreimbursed doses, and reduce administrative friction across the course.
Protect buy-and-bill revenue
Fewer preventable denials
Fewer disruptions between doses
Less time spent chasing payors
Greater cost clarity for patients
See Avico in your urology workflow
Book a demo to see how Avico manages NMIBC treatment access across your schedule.
Book a Demo