QOP Pharma runs clearly scoped operational services for specialty and regulated pharmacy workflows where “done” is defined upfront. Delivery is measured on completed, auditable outcomes, not hours, seats, or general activity.
PeopleProcessPerformance
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Pharma
Building stronger, more connected teams
Two pillars of scalable growth
Growth slows when clinical operations get overwhelmed. QOP Pharma addresses both workload and talent alignment. Our outcome-based pods handle specific operational workflows consistently, not vaguely by hours. One partner for managing workflow and execution, designed to scale with your operational priorities.
Built to scale growth
Work measured by results
Hire better talent
Outcome based operations support
QOP Pharma delivers clearly defined, auditable operational outcomes—never hours or seats. Pharmacy operations rely on us to remove recurring, high-volume tasks from internal teams without the overhead of adding permanent staff. By executing work consistently through strict completion rules, we ensure every task is documented and verified. Payment is tied only to these proven results, guaranteeing total accountability and operational transparency.
QUALITY OPERATIONS, QUALITY TALENT, REAL IMPACT,
A model built around defined outcomes
QOP Pharma provides outcome-based operations support, billing only for verifiable, completed work. We begin with a discovery call to identify priority services and define “done” for your workflows. Completion rules are agreed upfront, and workflows integrate with your systems. For tasks that cannot be standardized reliably, we also offer a traditional monthly option with a dedicated full-time specialist.
Our most requested services
Patient Access & Prior Authorization Support
Manage benefits verification and prior authorizations to prevent therapy start delays
We handle benefits verification, prior authorization submissions, status follow-ups, and coverage exception documentation as auditable work items. QOP Pharma tracks each request with a clear completion definition and evidence (reference numbers, logs, confirmations). Clinical decisions or approvals remain with your internal team, and any exceptions are escalated rather than guessed. Our focus is keeping therapy starts moving smoothly with predictable, verifiable outcomes.
Claims Denial & Rejection Support
Resolve rejected and denied claims through documented corrections and follow-ups
We manage rejected or denied claims end-to-end—triage, corrections, resubmissions, and status inquiries—logging each step as a completed outcome. QOP Pharma ensures that each denial action has proof of completion without touching payments or bank systems. Anything requiring policy, legal, or write-off decisions is escalated. The goal is to reduce backlog, clarify accountability, and maintain auditable records.
Patient Support Contact Center
Handle non-clinical patient and provider inquiries with clear routing and documentation
We handle inbound and outbound patient and provider interactions with clear dispositions and correct routing. QOP Pharma documents each step, ensuring work is auditable and nothing is lost in handoffs. If the interaction exists to complete another operational work item—access, enrollment, or outreach—it is recorded within that workflow to prevent duplication of effort.
Refill & Adherence Outreach Coordination
Run structured refill and adherence outreach to reduce missed follow-ups
We perform proactive refill and adherence outreach with structured follow-ups and disposition tracking. QOP Pharma logs each contact, escalates when clinical support is required, and schedules subsequent steps to maintain queue flow. The focus is repeatable, verifiable work items that reduce dropped follow-ups while routing any clinical decisions to licensed staff.
Copay & Assistance Enrollment Admin
Coordinate copay and assistance program enrollment paperwork and status tracking
We handle patient affordability program enrollment by assembling documentation, submitting packets, and tracking statuses. QOP Pharma ensures each submission has proof of completion, without handling funds or processing payments. All work is auditable, and enrollment actions are only counted as completed once submission and verification are logged.
Network Participation & Credentialing Admin
Prepare and track payer and PBM credentialing and network
We manage PBM and payer network applications, recredentialing updates, and follow-up responses with evidence tracking. QOP Pharma prepares and logs each packet, while your team retains sign-off authority for attestations and contracts. The service ensures completeness, timely submission, and predictable workflow so network participation approvals don’t stall.
Tailored Service
Custom work items built around your workflow
You tell us the workflow you want off your plate. We map it into clear work items, define inputs and “done,” set exception rules, then connect it to the right systems so delivery is consistent and auditable with QOP Pharma.
Dedicated Full-Time Specialist
Flexible tasks that do not fit our fixed outcome model
If a traditional model fits better, you can work with a dedicated full-time specialist through us. They focus on your workflows day-to-day, integrate into your tools where needed, and handle a wider mix of tasks that are hard to standardize into work items.
Frequently Asked Questions
Everything you need to know
How do we decide what services to start with?
We start with a discovery call, then prioritize the services creating the most operational load or the highest access, revenue, or compliance risk for your team, as long as they can be defined with clear completion rules. QOP Pharma only takes on services that can be scoped tightly enough to execute consistently.
How does work enter the workflow?
It depends on the service. Work can enter through system integrations, payer or platform triggers, scheduled batches, shared queues, or an agreed handoff with your internal pharmacy or operations team. The intake method is defined per service so work flows predictably.
Do you work in our systems or your systems?
Either, depending on what keeps delivery clean and trackable. Sometimes we operate directly in your pharmacy, access, or claims systems, sometimes we use ours, and sometimes we connect both so workflows stay aligned without duplicate work.
How do you define what counts as “complete”?
Each service is broken into outcome types with written, auditable completion rules. If evidence is required—such as a confirmation number, status change, record update, or log entry—that requirement is defined upfront so there’s no ambiguity at close.
How does pricing work?
Pricing is outcome-based. Each outcome type has a unit price tied to the completion rules. Most clients use a recurring service credit or minimum commitment, with usage applied based on completed outcomes. If volume exceeds the included amount, overage is billed using the same unit pricing. Items that are out of scope or blocked are not treated as completed outcomes.
What does onboarding look like?
We align on scope and outcomes, confirm the intake method, set up the tooling or integrations required, then run a short ramp to validate that completion rules match real day-to-day work. After that, delivery runs in steady state using the same definitions and pricing.
“We brought QOP Pharma in to take two things off our plate: owning a defined operational queue end to end, and running the follow ups so work did not stall after the first step. Within the first few weeks, we had clear work item definitions, a clean intake path, and a steady completion rhythm our internal team could actually plan around.
The difference is that it is not support hours or vague coverage. We can see exactly what was completed, what is in progress, and what is blocked. They connected into our systems and workflows, and we only pay for outcomes we can verify. Backlog stopped creeping, turnaround became predictable, and we eliminated a lot of internal time spent chasing status updates.”
Morgan Steele
Chief Operating Officer
Real stories of growth