Derm Dispatch: How Biologic Coordinators Like Ioana Coman, MSc, RN, CNA, Bridge the Gap in Patient Care

In this episode of Derm Dispatch, Renata Block, DMSc, MMS, PA-C, a board-certified physician assistant and instructor at Rush University in Chicago, Illinois, welcomes Ioana Coman, MSc, RN, CNA, a biologic coordinator at Medical Dermatology Associates of Chicago, to discuss her crucial role in patient care and biologic therapy coordination. Coman, who transitioned from a medical and surgical assistant role to her current position, has been a biologic coordinator for 3 years and has 9 years of dermatology experience.

Coman described her role as a full-time, detail-intensive position that involves coordinating with physicians, patients, pharmacies, insurance companies, and assistance programs. While she works remotely, she notes that although it lacks the immediacy of in-person interactions, it allows for greater focus and fewer distractions.

“Every day brings something new,” Coman said. “But one thing that stays the same is the high-level attention to detail.”

To streamline the biologic approval process, Coman created a comprehensive protocol used by both staff and patients. This protocol outlines steps such as prior authorizations, enrollment forms, appeals, and pharmacy coordination. She stresses the importance of detailed clinical documentation—including metrics like BSA (Body Surface Area), EASI (Eczema Area and Severity Index), and IGA (Investigator's Global Assessment) scores—for securing insurance approval. Block and Coman emphasized that quality of life documentation is equally critical, especially when visible symptoms may not reflect the patient's suffering.

Coman begins working with patients immediately after their visit, explaining the process and offering clear communication and emotional support. She also manages expectations, informing patients that biologic approvals typically take 2 to 4 weeks, but potentially longer if appeals are necessary. Quick Start or bridge programs help prevent treatment delays.

She also handles challenges like denials, off-label usage, or insurance-mandated biosimilar switches, educating patients and coordinating supporting documentation, such as scientific articles and clinical photos, to strengthen appeals. Currently, she manages biologics for 9 providers and coordinates across 22 different biologic medications.

To excel in her role, Coman highlighted the importance of patient care experience, strong medical knowledge, communication skills, and organization. She also leverages pharmaceutical trainings, support tools, and insights from patient experiences to stay informed on all the trends and new drugs coming to market. Her dedication and systematized approach significantly improve patient access to life-changing therapies.