Expires 04/01/2021

Specialty Pharmacy

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Alto Pharmacy Technician

Alto Pharmacist

Our mission at Alto is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it.

Services that reduce travel and encourage social distancing are now more essential than ever, not only for vulnerable populations but all of us as members of our communities. Alto’s free same-day doorstep delivery ensures you have safe and reliable access to medications in this time of uncertainty. 

Hear first-hand from members of the Alto technology teams.

Alto / Blog

We want to support you in preparing for your best health. PrEP, or pre-exposure prophylaxis, is an HIV prevention method that's available by prescription. Learn more about who should take it, how effective it is, and possible side effects.

All about PrEP for HIV Prevention

PrEP, or pre-exposure prophylaxis, is an HIV prevention method that's available by prescription. It isn’t a vaccine, though its purpose is similar. It’s a pill that’s taken every day to protect you from infection if exposed. 

With consistent use, the medicine remains present in the bloodstream of an HIV-negative individual. Then, if they’re exposed to HIV, it will block the invading virus from spreading throughout their body. 

According to the CDC, PrEP has been shown to reduce the risk of getting HIV from sex by 99% with consistent use. And it can even reduce the risk for intravenous drug users by 74% if taken daily.

Anyone who is HIV-negative and at risk for HIV infection can choose to take PrEP. PrEP may be right for you if you have a partner who is HIV positive or you do not know their HIV status, are a man having sex with men, are a trans masculine person having sex with men, are a trans feminine person having sex with men, have sex without condoms, are a sex worker, use injection drugs, or are concerned about HIV infection. Your healthcare provider can let you know if PrEP is the right choice for you.

There are currently two FDA-approved medications for PrEP: Truvada® and Descovy®. Both are oral medications that are only available by prescription. Your doctor will let you know which is best for you. Since PrEP should only be taken by those who are HIV-negative, you will need to take an HIV test before you can receive a prescription and also every three months while you’re taking it. You will also need to take a general blood test every six months. Staying on PrEP is a commitment, but these follow-up appointments are crucial for your health. 

Not all providers and health clinics offer PrEP,  but HIV.gov maintains an HIV Services Locator that will help you find a provider near you. 

Telemedicine is an option that can also make the process more accessible—and many more healthcare providers are offering remote consultations. Telehealth services allow you to schedule a phone or video consultation with your healthcare provider then use at-home test kits to complete any required testing through the mail. Talk to your healthcare provider to learn more about this possibility. 

PrEP is usually covered by most insurance plans, including Medicaid. There are also patient assistance programs that can help you access PrEP at a low cost or even free. The Gilead Advancing Access® program offers a copay coupon card for those with insurance and a Medical Assistance Program for those who are uninsured. They’ll help you find out if you’re eligible and may be able to suggest alternative sources of financial support if you are not. If you’re not sure if your insurer will cover your prescription, our team is here to help. We can inquire on your behalf and ensure you get the lowest price. 

Some people may experience side effects like nausea, diarrhea, headaches, and dizziness, however, they usually subside over time. Serious side effects aren’t common, but you should tell your provider if you notice any unusual symptoms. Your doctor will also be monitoring your blood work.

No—and this is important. PrEP needs time to build up in your bloodstream before it can effectively fend off an HIV infection. It will take a period of continuous use (usually at least one week or one month) before it is fully effective, so talk with your doctor about your specific time frame. If you’re engaging in sexual activity, be sure to use another form of protection in the meantime. You can also speak with a pharmacist at Alto if you have questions about how your medication works. 

And remember—if PrEP isn’t taken every day, there may not be enough of it present in your body to prevent infection. It’s extremely important to be consistent. Also, PrEP only protects against HIV infection, so you’ll need to continue using condoms to protect against other sexually transmitted infections (STIs). 

We recommend talking it over with your provider. If they do write you a prescription for PrEP,  the team at Alto can support you through the process of obtaining your medication. Our pharmacists are always here to answer your questions, from how to take it to what to do if you miss a dose. We’ll also deliver your prescription for free, send you quarterly lab reminders, and show you how to use the Alto app to set up daily reminders to take your pill. 

If it’s right for you, the decision to take PrEP is an important commitment to your health and well-being. We’ll be here to make sure the next steps are as easy as possible. 

We want to support you in preparing for your best health. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-5881, or download the mobile app for secure messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Since 2016, Alto has supported over 20,000 patients through their fertility journey. In this post we'll provide guidance on how to select the right fertility pharmacy. In addition, we'll share the benefits of selecting Alto as your fertility pharmacy. 

What to Consider When Selecting a Fertility Pharmacy

Your Choice of Fertility Pharmacy Matters

Chances are if you’re reading this you’ve made a decision to undergo fertility treatment or know someone who might be soon. To begin with, know that you are not alone. Approximately 1 in 8 women in the US are affected by infertility, and more than 20,000 women have now decided to have their eggs frozen. 

Since 2016, Alto has supported over 20,000 patients through their fertility journey, and several team members have gone through the journey themselves. We know this can be an emotionally, financially, and physically challenging experience. That’s why we believe choosing the right pharmacy can help you avoid additional stress caused by waiting for hours on hold, tracking down your medication delivery, and navigating insurance benefits.

Think of your pharmacy as an extension of the care you receive from your physician. You wouldn’t choose just any fertility clinic, right? The same goes for where you choose to receive your fertility medications. Fertility treatment is stressful enough. Your pharmacy partner should provide the reassurance and reliability you deserve.  

In this post we'll share guidance on how to select the right fertility pharmacy. First, we’ll explain why it's important to use a pharmacy with a strong fertility focus (versus any neighborhood or mail-order pharmacy). And since not all fertility pharmacies are the same, we’ll also offer five considerations to make sure you have the smoothest experience possible. Finally, we’ll share the benefits of selecting Alto as your fertility pharmacy. 

At a minimum, credible and experienced fertility pharmacies will employ:

An expert clinical team: This includes pharmacists who are knowledgeable on and experienced with the medications and dosing unique to fertility treatments.

Temperature controlled packaging: Medications can go bad if they are not shipped or stored at the proper temperature. Fertility pharmacies will provide the appropriate packaging to ensure your medications arrive in good condition. This is especially important in warm climates. 

Proper supplies: Fertility pharmacies will be familiar with the variety of needles/syringes that you may need for your injection. This is crucial because it can be stressful if incorrect supplies are included which may lead to a missed dose. In addition, supplies such as alcohol swabs and disposal containers should always be included.

Learn more: [The View From Both Sides of the Fertility Pharmacy Experience]

Here are five additional things you should consider when selecting a pharmacy partner: 

1) Easy, proactive communication - After your clinic sends your prescription to the pharmacy you’ll likely have questions related to insurance, what to expect when receiving your medications, and most importantly, when they will be ready. For that reason it’s important to take into account what types of communication are offered - phone, text, email, mobile app - and typical response times and operating hours. Pharmacies with weekend/evening support hours are most beneficial in ensuring you’ll get live support when you actually need help.

2) Affordability assistance - Fertility benefits are confusing and it can be hard to understand just how much you’ll need to spend on medications. Most fertility pharmacies will work with leading financing and loan providers and can administer manufacturer discount programs if asked. A great fertility pharmacy will go above and beyond to connect you with financial assistance programs for qualifying prescriptions.

3) Local, timely delivery - Your medication protocol can change even after you start your injections - perhaps your physician wants to add a different trigger shot to prevent over-stimulation or decides to add days to your schedule because of the rate at which your follicles are growing. You can avoid these stressful situations if you select a pharmacy that is local and can promise fast same-day delivery. The last thing you need to worry about is mail-order delays or waiting in line at a pharmacy for hours. 

4) Pharmacist support - You’ll most likely have questions about your fertility medications (i.e. How do I know I’m injecting correctly? My clinic just changed my medications, what do I do?) so think of your fertility pharmacist like an extension of your #TTC community in that they should be an advocate on your side. Make sure the pharmacy you choose offers support and expert resources like guidance on injections, tools for managing your protocol and help understanding medication options - including late at night and on the weekends!

5) Community reviews - Just like you researched clinic and physician reviews, you should do the same with your pharmacy choice. Head to Yelp, Facebook, and any other feedback platform that showcases patient testimonials. Pharmacy experience matters but so does the experience of others. See if any reviews or blogs exist that mention specific fertility pharmacies. You’ll thank yourself (and those before you) for taking the time to do your due diligence. 

The fertility team at Alto will reach out as soon as we get your prescription so you don’t have to worry about waiting on hold or standing in line at a pharmacy. We’ll proactively investigate your insurance coverage, provide options to maximize your benefits and offer qualifying rebate programs. 

And because we know you’re busy with life, we offer a mobile app that allows you to securely schedule your delivery or message a pharmacist if you aren’t able to call us. You can take care of your pharmacy needs wherever you are and on your schedule. Alto pharmacists are always available until 9 pm each night (including weekends) to answer questions. 

When it comes to the time sensitive nature of your treatment, being locally-based makes a critical difference. Medications may be increased, decreased, or stopped altogether. At Alto, patients always receive free, same-day delivery by our own Alto courier team, even on weekends. 

We also offer the ability to select the 2 to 3-hour delivery window that works best for you either at home or work. Once your delivery is scheduled you’ll receive text updates along the way so you know exactly when your courier will arrive.

Your medications are packaged to give you the necessary information to avoid common mistakes (e.g.which meds go into the fridge). And Alto’s dedicated fertility pharmacists are always just a phone call or text away to answer your questions about injections, supplies, and more. So if you're about to inject and suddenly forget something, you don't need to wake up your physician - you can give us a call.

We’ll also follow up with you to remind you about qualifying rebates and provide instructions on how to apply. Our patients find this especially helpful given they have enough to remember. 

Sam shares why serving fertility patients is so rewarding

The team at Alto is ready to be your partner through it all, from your first cycle to your last. Questions about using Alto? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends. 

What to Consider When Selecting a Fertility Pharmacy 

When it comes to critical pharmacy needs, patients with diabetes often feel like they’re navigating the complexities of their care paths with very little control or clarity. That’s why we feel it’s important to highlight how Alto can help provide relief in managing your medications.  

The Best Pharmacy for Your Diabetes Care

Millions of Americans suffer from endocrine disorders, caused when hormone levels are either too high or too low or when the body doesn’t react to hormones the way it’s supposed to. Some of the most common endocrine disorders include Type 1 and Type 2 Diabetes (which affect over 30 million Americans), thyroid disorders (over 20 million Americans) and osteoporosis (10 million Americans). When it comes to critical pharmacy needs, patients with endocrine disorders often feel like they’re navigating the complexities of their care paths with very little control or clarity. With so many medications, prescriptions are often filled at different times, resulting in numerous trips to the pharmacy and disruptions to daily life. That’s why we feel it’s important to highlight how Alto can help provide relief in managing your medications.  

Meet Josh. Josh has Type 2 diabetes, an endocrine disorder that affects the way his body processes blood sugar (glucose). He visits his local pharmacy two-to-three times a week to pick up his various medications and medical supplies, which are each filled at different times. When he’s at the pharmacy, he is faced with long drive-thru lines or crowded store aisles and phones ringing off the hook. There have been times when Josh has arrived to pick up one of his medications or his insulin pump only to find out that they are no longer covered by his health insurance. Along with the burden of scheduling various pick-ups and dealing with unexpected costs, Josh worries there will be a time when he needs one of his critical medications, and he won’t be able to reach his pharmacist for help. 

Many of the brand-name medications commonly prescribed to diabetes patients simply aren’t covered by health insurance plans or come with strange restrictions. Patients can arrive at their pharmacy to find that their medication is only covered for their first “x” doses, or in some cases, not covered at all. Left with the stressful decision of whether to pay higher-than-expected prices or return home empty-handed this can often deter treatment from starting on time.

No guaranteed access to medication or their pharmacist

People living with diabetes often suffer from multiple comorbidities, increasing the complexity and number of their medications. With so many medications, prescriptions are often filled at different times, resulting in numerous trips to the pharmacy and disruptions to daily life. Retail pharmacists can be difficult to get a hold of, especially with the increasingly long lists of administrative tasks they are asked to complete. Diabetes medications are critical: missing one dose or experiencing one contraindication can be life-threatening. Added time spent waiting for a pharmacist to answer can be stressful and, in some cases, dangerous.

Doctors are often kept in the dark along with their patients when it comes to costs and insurance- based restrictions on medications. The current system is designed such that doctors often have to perform investigative work and complete prior authorizations with insurance in order to get a patient’s medication covered, meaning hours of extra calls and paperwork. When someone like Josh has an issue with the cost of their medication, they can’t simply swap it out for a new one. They have to connect with their doctor who can perform the necessary research to find them a new medication.

At Alto, we believe that everyone deserves exceptional pharmacy care. We are here to reduce the stress and confusion that comes with navigating insurance, and we offer transparent, consistent communication so you always understand your options. Our specialty pharmacy team will help sync your many medications into one delivery, get you set up on automatic refills, and work with your doctor on any prior authorizations needed for your medications.

Our pharmacists and billing specialists work with doctors and health insurers proactively to ensure the medications you are prescribed will be covered. We take on the investigative work and communicate the cost upfront so there are no surprises. We ensure you get the best prices on your medications - including branded oral and injectable medications - and we automatically apply any coupons or copay cards.

We’ve created a team of patient care pharmacists who are solely dedicated to answering questions and walking patients through their medications, so you’ll never spend 40 minutes waiting on hold. We provide real-time support via our mobile app or over the phone seven days a week, including evenings. If you have questions around a refill or need a refresher on injection instructions, you have direct access to help.

We deliver medications directly to your doorstep - for free! - and eliminate those dreaded, numerous trips to the pharmacy with crowded aisles, long wait times and no sense of privacy.

With Alto you’re always in control over when you want to receive your medications. Simply choose the delivery window that’s best for you and track your courier in real time. 

Ready to get started or want to learn more about Alto? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text or the app.

A new diabetes diagnosis can come as a shock—and then comes the avalanche of information. Here are a few things you should know now to feel empowered about your health.

Managing Your New Diabetes Diagnosis

A new diabetes diagnosis can come as a shock—and then comes the avalanche of information. While it’s completely understandable to feel overwhelmed, we assure you, your confidence will grow as you get a good grasp on the basics. Here are a few things you should know now to feel empowered about your health.

There are many genetic and environmental factors that played a role in your diagnosis. Having diabetes means your body isn’t functioning as it should, and that is not your fault. What matters is what you can do to improve your outcome going forward. 

Diabetes isn’t curable, but it is absolutely manageable. With care and consistency, you can live a long and healthy life. Though there can be very serious consequences if the disease progresses without treatment, know that these outcomes are largely avoidable. Commit now to following your treatment plan and learning everything you can about your diagnosis. You won’t be alone—our pharmacists and care specialists will be there to help. Your lifestyle will play a large role in managing this disease and that’s great news. It means you have power over your future health.

At first, keeping track of your health stats may make your head spin. Know that it gets easier, and soon you’ll be a well-versed pro. To start, the National Institutes of Health (NIH) recommends getting to know three important numbers:

A1C - This blood test will provide insight into your blood sugar levels over the past few months so you’ll know if your treatment has been working. 

Blood pressure - Diabetes puts you at a higher risk of heart disease, so it’s important to keep this number in a healthy range.

Cholesterol  - Diabetes and high cholesterol often go together, which can further increase your risk of heart disease. 

Your doctor can help you understand what your target numbers should be and how you can stay within a safe range. Your goal numbers will be unique to you, so be sure to fully discuss them with your healthcare provider and set up a plan for regular testing and checkups. 

You’ll likely need to test your blood sugar on your own, either throughout the day or from time to time. This will help you determine how your medications, specific foods, and certain types of exercise impact your blood sugar levels, as well as other factors like stress. Your doctor will let you know how often you should test and what your target range should be. 

Logging your results will help you notice patterns and see your progress. The Diabetes Teaching Center at the University of California, San Francisco offers a free, printable logbook that can help you get started. You can also use an app like Glucose, or mySugr which will take care of much of the work for you, allowing you to set reminders and view trends over time. 

In most cases, you’ll need to take medication. With type 1 diabetes, you’ll require some form of insulin therapy—either injections or an insulin pump. Treatment can be quite varied for type 2 diabetes. You may need insulin, oral medications, both, or none at all. Your doctor may also prescribe medications for high blood pressure or cholesterol.

It’s important to know that type 2 diabetes is a progressive disease, and your treatment may change over time. However, changes in your prescription are not an indication that you’re failing somehow. Your goal should be focused on maintaining normal blood sugar levels and keeping those important numbers in a healthy range, not on which medications you’re taking. 

We know this is a lot to take in, so the patient care pharmacists at Alto can provide you with a free consultation to discuss your medications. From answering questions about side effects to helping you set up dosage reminders, we’ll help you feel confident and informed. 

Food and exercise affect your blood sugar levels, so you’ll need to pay close attention to both. It’s not just about what you eat, but the size of your meals and the balance of carbohydrates, protein, and fats. You don’t need to cut out carbs completely, but you’ll likely need to learn to count them to make managing your blood sugar easier. The CDC offers a great breakdown of how this works and enlisting the help of a registered dietician can take some of the pressure off as you learn. 

Like the rest of your care plan, this will become more and more effortless with time. At least for now, we recommend finding resources with recipes that are designed specifically for diabetes. The American Diabetes Association’s Food Hub and Eating Well’s Diabetes Diet Center are excellent places to begin. 

In addition to the testing we already described, you should plan to get a yearly physical and eye exam and see a dentist every six months. Diabetes complications can cause damage to your eyes, nerves, kidneys, and gums, but controlling your blood sugar and getting regular check-ups will help you detect any issues early and prevent these problems.

It’s important to let those closest to you know about your diagnosis. There will be times when you get frustrated or discouraged, so make sure you have someone to confide in when you need support. 

To get a better idea of what a happy and healthy life with diabetes can look like, join some of the many online communities that are available on almost every social media platform. Try searching “diabetes” within Facebook’s groups or exploring the American Diabetes Association’s online Support Community to start connecting with others who can truly understand what you’re experiencing. 

Lastly, if you think you might be experiencing depression, or your mental health is suffering in any way, please seek out help from a mental health professional. Ask your doctor if they can refer you to someone who specializes in chronic health conditions. Please don’t try to go it alone, there is so much support available to you. 

We know there’s a lot to unravel with a new health diagnosis, but this information is meant to empower you to thrive. While you undertake the task of learning and adjusting, we’d be happy to take care of your prescriptions—walking you through your first insulin injection to delivering medications right to your door. 

Interested in switching to Alto? We’ll handle the transfer. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text or the app.

The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

How to avoid postal delays and pharmacy lines with Alto

Concerned about Mail Delays tying up your Prescriptions? There’s a Better Way.

With the pandemic pushing many to avoid lines at the pharmacy, more Americans than ever are receiving their prescriptions through the mail. Last year, over 170 million prescriptions were filled by mail in the United States. According to a recent report, that number has increased by 20% since the onset of COVID-19. 

Recently, sweeping policy changes within the United States Postal Service have led to significant delays, with everything from Amazon packages to mail-order prescriptions becoming increasingly bogged down. Now, two U.S. Senators are voicing serious concerns, saying the delays are putting the health of millions of Americans at risk. 

Switch to a better pharmacy and enjoy free same-day delivery

In a recent investigation of five major pharmacies offering mail-order service, Senators Robert Casey (D-PA) and Elizabeth Warren (D-Mass.) found an increase in average delivery times ranging from 18-32%. That means millions of people with chronic conditions like diabetes, heart disease, and asthma are facing a dangerous dilemma. They can either risk unnecessary exposure to COVID-19 knowing they are especially vulnerable to the virus or possibly go without life-saving medications for days due to delays in the mail. 

Alarmed by the striking slow down, Jacqueline W. Fincher, MD, President of the American College of Physicians, released a statement cautioning that “a delay in receiving a necessary prescription could be life-threatening. My patients who rely on their insulin, or their inhalers, or any other type of medication can’t wait weeks to see whether or not their prescription will be delivered.”

This situation is certainly troubling, however, at Alto, we promise to deliver a better experience. Here’s why our courier service is the best method for ensuring your prescriptions arrive safely and on time.

Same-day, contactless delivery: We skip the mail, preferring to hand-deliver your medications that very day. We also provide contactless drop-offs to ensure everyone stays safe.

Zero risk of in-transit delays: Your prescriptions will never change hands during the delivery process, increasing not only speed, but safety as well

Convenient scheduling: Select from multiple 3-hour delivery windows that work best with your schedule

Real-time tracking: Stay updated throughout the delivery process via text or follow along in real-time in the Alto app.

Always free - There are never any hidden fees—your delivery is completely free. 

We’re committed to helping you lead a healthier life by providing swift and safe access to the medicine you need. Making the switch to Alto is easy. We’ll handle the transfer.

Concerned about Mail Delays Tying up Your Prescriptions? There’s a Better Way.

At Alto, we believe you shouldn’t have to stress over savings. In this blog post, we’ll share how our team works to reduce your cost.

How Alto Saves You Money on Prescriptions

Finding the lowest price for your medications shouldn’t be a hassle. Yet with countless options like rebates, manufacturer coupons, and discount saving programs, knowing where to start can be confusing. Add to that recent headlines that seem unclear and it’s no wonder the search for discounts often leads to frustration. At Alto, we believe you shouldn’t have to stress over how to save on your prescriptions. 

In this blog post, we’ll share how our team works to reduce your cost for most insurance-covered prescriptions. Keep in mind that certain treatment options, such as fertility, often require additional benefits investigation or aren't covered by traditional insurance. If your prescription isn't covered by traditional insurance we can also help with the approval process. But first, let's quickly review how pricing is set. But first, let’s quickly review how pricing is set. 

Your insurance plan contracts with a pharmacy benefits manager (PBM) whose job is to determine which medications should be covered or not under your insurance plan (even down to the exact dosage and brand that your doctor prescribes). This creates preferred coverage - and therefore pricing - for certain medications.

The PBM negotiates with the drug manufacturers to agree upon a specific price to charge the insurance plan for a medication, the remaining copay that you’ll be responsible for covering, and the PBM’s fee for administering the service.

Pharmacies purchase drugs from third party wholesalers or directly from manufacturers. If you plan to use your pharmacy benefits to pay for your medications, your out-of-pocket price is determined by the PBM+insurance plan. If you’re not using insurance, the pharmacy will provide a cash price.

Some drug manufacturers will also offer coupons, copay cards or financial assistance programs to help patients afford particularly expensive or new-to-the-market medications. 

Confused? Don’t worry. That’s why we’re here to help. 

Need more details? Read Breaking open the black box of medication pricing

We believe medication pricing should be transparent and that you shouldn’t have to investigate savings options on your own. The infographic below compares Alto’s cost saving measures to traditional retail pharmacies and how this impacts your overall cost. 

Every prescription sent to Alto is matched against our database of coupons, copay cards, and other savings options (like manufacturer-sponsored assistance programs). We automatically apply any savings we find so that you can trust you’re always getting the best price. If paying out of pocket will be the cheapest option, we'll be sure to let you know. 
Medications still too expensive? Let us know and we'll work with your doctor to identify alternative medication options, if available. Our price investigation services are completely free. 

A good pharmacy should never leave you to do the pricing legwork on your own. If you’re in the process of finding the right partner for your prescriptions, make sure cost savings assistance is part of the deal. Your financial wellness matters too.

“As a veteran pharmacist, I’ve never witnessed other pharmacies apply the same cost saving services that Alto does automatically,” shares Luisa Nazareno, Patient Care Pharmacist. “Our team understands that price can be a limiting factor in fulfilling prescriptions so we work tirelessly until we can provide our patients the most affordable option. It’s really rewarding to know that we’re helping patients save money and stay on track with their treatment plan.” 

Questions about Alto or pricing on your medications? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text or the app.

We took the best parts of the software engineer interview process from the places we’ve previously worked and interviewed, eliminated stuff we thought wasn’t relevant, and added our own special Alto ingredients!

What to Expect When You Interview as a Software Engineer at Alto

Thank you so much for considering an interview at Alto! At Alto, we’ve devoted a considerable amount of time refining how we interview candidates for software engineering roles. As engineers, engineering managers, and recruiters at a rapidly growing company, this is a big part of our jobs and we want to get it right: for the candidate, for ourselves, and for the team. We took the best parts of the interview process from the places we’ve previously worked and interviewed, eliminated stuff we thought wasn’t relevant, and added our own special Alto ingredients. Let’s dive in!

What does a Software Engineer at Alto do?

First and foremost, Alto exists to serve our patients--whether that be via building products, or providing exemplary service. Engineers at Alto are empowered to go the extra mile to make an impact for our patients, medical providers, and amazing pharmacists and care professionals. We are organized into small mission-focused teams where you will be working closely with Product Managers, Designers, Data Analysts, Data Scientists, and our Care team. Alto Engineers enjoy this cross-functional, collaborative environment where everybody has a voice in the direction of the product and the team. Compared to other companies, we are more end-user focused in most of our teams, even those that work primarily on platform and infrastructure.

Our pragmatic focus on impact includes making sure that we fulfill our company value of Patients Come First. We have a strong culture of code reviews, testing, documentation, and knowledge sharing to ensure that the service consistently meets our patients’ and providers’ expectations for quality and reliability.

Developing a Predictive Interview Process to Reduce Unconscious Bias

We want our engineering team to look like our customers — and we strive to serve everybody. Our mission is to fulfill medicine’s true purpose — to improve the quality of life — for everyone who needs it. In order to effectively carry out our mission, we believe our engineering team should reflect the rich diversity of our customers. Our engineers come from all backgrounds and took many varied paths to arrive here: self-taught, coding bootcamps, and top-tier universities. Prior experience ranges from none to decades at large public tech companies with many joining from other startups and consulting/contracting backgrounds. Reflecting this, we’ve put together an interview process that focuses on predicting job success over testing for rarely-used computer science knowledge and encourages hiring diversity of all kinds rather than filtering for a certain type of engineer.

Throughout the interview, we work on problems that are facing Alto today or that we’ve dealt with recently. Our interview questions rarely have a “right” answer, and if you are writing code, any language works. (We spend our time mostly in Javascript, Ruby, and Go.) Occasionally, you will have more than one interviewer in the session. This is likely because one interviewer is shadowing the other to train, get calibrated, and learn how to deliver and interpret the questions while minimizing bias.

This is a quick chat with a recruiter or a hiring manager to further expand on your experience, capabilities, and interests. Based on this, we’ll have a good idea for which team(s) you would be the best match.

This screen aims to validate your technical skills. You’ll be working in a networked IDE (like CoderPad) with an Altoid (what we call ourselves) to write and run code that addresses a typical problem that you might face at Alto. We’re looking for fluency in the language of your choice and some fundamental object-oriented programming design skills. 

This is based on a typical task that you might face at Alto - something like designing or interfacing with an API. You're welcome to use StackOverflow, Google, or any other resources at your disposal—including your interviewer! We’ll be observing how you understand the problem, communicate with your interviewer to develop requirements, and get to working and well-tested code. 

In this section, you’ll spend some time getting to know a problem we have faced. You’ll spend 10-30 minutes working on how to approach and optimize a challenge that impacts our business everyday, then show that you can translate that into working code.

This module varies depending on your experience and interests. For some folks, we dive deeper into software design and learn how you would break up a hypothetical application into core modules. For senior frontend developers, this might be an app architecture challenge. And for senior backend developers, we’ll address systems architecture with an eye toward scalability, observability, and technology choices. In every case, we’re looking closely at how you approached the problem, gathered requirements, and justified your decisions.

The Engineering Manager is trying to deeply understand who you are as an engineer and a person. What do you get excited about? What type of roles do you like taking on within a team or project? What is your career arc and how can you best advance that at Alto? The questions often asked are behavioral or hypothetical in nature, and we love to hear stories about your proudest accomplishments and challenges you’ve overcome.

“I had an amazing interview experience with Alto - although the recruiters were super busy, they made sure to accommodate my timeline," shares Jacinda Zhong, Software Engineer, Core Services at Alto.  "I was really pleased to find out that Alto asks questions based on the type of work I’d be doing - no obscure CS concepts, and questions centered around complex business logic that you’d encounter working at Alto. Before my onsite, my recruiter gave me a call to provide context on what they’d be asking. No gotchas and no surprises, plus lots of detail so that I could be prepared to do my best. So excited to be working here and contributing to a great mission!”

The interviewers get together promptly—we try to do it no later than the next day—to discuss next steps. Prior to our discussion, we individually assess your performance against a rubric that takes into account your level of experience and the requirements for the role.

There is rarely unanimity in the panel. Almost everybody at Alto was discussed in a panel where there were some mix of Yeses and Nos. Often, we ask ourselves questions like, “What is the candidate’s superpower?”, “What will they add to the team?”, and “For which open role are they the best match?” Our hardest decisions are the ones where we all agree that the candidate is somebody we want to work with but we don’t have exactly the right role.

Don’t be surprised if your interview is slightly different from what is described here. We’re constantly refining our process to get to better hiring decisions more quickly and with less bias with regular feedback from candidates, interviewers and recruiters. 

Have you had an interview experience that you thought was exceptional? Let us know at feedback@alto.com.

In this post we’ll define what a prior authorization is, 3 tips to plan for them, and how Alto provides support in the process.

What is a Prior Authorization?

Imagine going to your doctor’s office and receiving a treatment plan only to learn that your medication or procedure needs approval, commonly referred to as a prior authorization (PA). This might seem odd given that your physician recommended your prescription or procedure as the best option. However, the approval isn’t required from your doctor but rather your insurance company. This is to ensure that the treatment complies with their coverage standards. 

A prior authorization is a request to your insurance company for coverage of certain medications or medical procedures. You can think of a prior authorization as the “green light” to proceeding with your physician’s recommended treatment plan. Insurance companies typically require this approval process for the following situations: 

Medications that may be misused, abused or have adverse effects

Medications that are new to market and not yet listed on insurance formularies (i.e. may be at a higher cost than other drugs that are similar/more cost effective) 

Medications that your doctor prescribed to treat a condition other than those officially approved by the FDA, also known as "off-label use”

Medical treatments or procedures where medical necessity requires assessment

Why are Prior Authorizations so Important?

A recent study shows that 1 in 4 doctors believe the prior authorization process has a disadvantageous effect on their patients’ well-being due to delays caused in treatment. Despite this, prior authorizations remain a key part in gaining insurance approval. Put simply, this is their way of “gatekeeping” cost effective coverage appropriate for each patient. 

At Alto, we understand why insurance companies want extra due diligence on expensive or risky medications, but we don't think patients should have to navigate this complicated world on their own. And these hurdles/hoops should never substantially delay access to treatment. That’s why we proactively file prior authorizations when they are needed, ensuring there are no delays. In fact, we have a dedicated support team who works closely with your doctor’s office the moment a prescription comes in that requires approval. We’ll also always keep both you and your physician in the loop throughout the process so you know the current status of the request. 

Ask your doctor if a prior authorization might be necessary when discussing treatment 

Consider a pharmacy, like Alto, that is action-oriented in filing prior authorizations (and we offer this support for free!)

Don’t be discouraged by the process. While this might be an extra step it’s likely to save you from paying full-price. 

Regardless of whether or not you may need a prior authorization now, it’s helpful to understand what to expect so that you are prepared. In the event that the prior authorization request is denied, we will work directly with your doctor to either process an appeal or find covered alternative treatments so that you don't have to. 

In some cases such as fertility medications, we will help you to understand your out-of-pocket costs and to identify alternative sources of financial assistance to ensure you're getting the best possible prices. Gaining access to your medications isn’t limited by a prior authorization, and with the right pharmacy partner you can feel confident that you’ll have an advocate on your side. 

Questions about Alto or our cost savings approach? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text or the app.

In this post we'll explain what causes medication side effects, how to manage them, and provide 5 suggestions to remedy. 

How to Manage Medication Side Effects

From the occasional skin rash to more chronic illnesses such as diabetes, prescription drugs are often critical in treating or even preventing symptoms and improving overall quality of life. All medications carry the potential for complications or other symptoms known as side effects. From periodic nausea or upset stomach to more adverse effects such as liver or heart problems, each medication carries its own potential for introducing ailments unrelated to the original diagnosis. In this post we'll explain what causes side effects, how to manage them, and provide 5 suggestions to remedy. 

What is a medication side effect and why does it matter?

Put simply, medication side effects are unexpected reactions that can occur as a result of using a prescription, over the counter medication or herbal supplement. There are two types of side effects: common and adverse. Common side effects are generally described as “normal” after-effects of treatment such as constipation, dizziness, dry mouth, headaches and skin rash. Adverse side effects are much more serious and can include internal bleeding, kidney damage and heart dysfunction among other symptoms. 

The main difference is that common side effects are unwanted, but known, while adverse side effects are unintended, and often not accounted for in treatment plans. Side effects can vary with all medications, so it’s important to understand what is common and what is adverse with the particular medication you are taking. Side effects are also not always dose dependent, meaning that they can occur at any dose or strength; some side effects, however, are worse or more pronounced the higher the dose. It's always important to take the medication as prescribed by your provider and to not increase your dose without first consulting your physician.

1) Communicate with your healthcare professional: Informing your healthcare provider of any allergies or known reactions to medications before starting a new medication can reduce the possibility of side effects. Be sure to also include all disease states past and present as this will help your doctor make the best choice for your medical care. New patient intake forms or patient portals usually provide an opportunity to list any known reactions to medications. Otherwise, be sure to update your doctor if anything has changed since your last visit. 

2) Discuss current medications: Transparency is key for all members of your healthcare team. If you have multiple doctors or pharmacies for different treatment plans, be sure to keep them each informed of all your current medications, including over the counter medications such as pain relievers and wellness supplements such as multi-vitamins or herbal supplements. Full-service pharmacies like Alto make it easier to track all of your medication needs in one place.

3) Review the patient package insert (PPI) included with your prescriptions: All prescriptions include a PPI that contains information on the medication, indications and usage, contraindications, warnings, precautions, and dosage administration. This is a quick way to reference any possible side effects so that you know what to be on the lookout for. Take the time to read it and reach out to your prescribing physician or pharmacist with any questions. 

4) Contact your pharmacist: Pharmacists are responsible for patient safety and often act as the bridge between a patient and physician when there are questions about a patient's medications. Pharmacists review all of a patient's current medications to identify any potential adverse effects, and are available to answer questions about your medications' intended use and effects. Look for pharmacies that make it easy for you to ask questions; Alto's pharmacists are available via phone, text and secure message in our mobile app.

5) Be open to alternatives: Stay in contact with your doctor to discuss potential changes to your treatment plan if side effects present a problem. Your physician can evaluate other medications or treatment options if appropriate; simply forgoing treatment without consultation with your healthcare provider presents additional risks and is not advised.

Keep in mind that not all medications will produce side effects and not all side effects will be significant enough to change the course of your treatment. It’s important to pay attention to how you are feeling both before and after taking prescribed medications and to always stay in touch with a healthcare provider to discuss any unexpected symptoms or changes. For more information on how to manage your medications check out this article from Alto.  

Looking for a partner to help you manage your prescriptions? Our team is available to answer your questions from 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text, or theapp.

The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Alto is committed to ensuring affordable, timely access to medications and full-service pharmacy coverage, including specialty medications for the treatment of complex and chronic conditions.

Hims & Hers, the direct-to-consumer digital health company, has partnered with Alto Pharmacy to offer free, same-day courier medication delivery for customers accessing primary care services through its growing telehealth platform. 

Patients using the Hims & Hers platform to access primary care services in the San Francisco Bay Area, Los Angeles, Orange County, Seattle, Las Vegas and Denver-Boulder communities will have the option to select Alto as their preferred pharmacy for prescription delivery. Prescriptions for patients selecting Alto will flow automatically to Alto for fulfillment, and patients can use the Alto app to select their preferred date and time for free home delivery, review copay and medication info, and message a pharmacist with any questions. 

“At Alto, we’re constantly looking for new ways to improve the healthcare and pharmacy experience and we’re excited to partner with Hims & Hers to offer free, same-day courier medication delivery for their patients,” says Omar Nagji, Vice President of Enterprise at Alto Pharmacy. “Our partnership with Hims & Hers offers patients control, discretion, and pharmacist access without making a trip to a doctor’s office or pharmacy.”

“Hims & Hers is a natural partner to Alto’s courier-based platform,” says Melissa Baird, COO of Hims & Hers. “We’re excited to work with Alto to bring the ease and convenience of their same-day delivery experience to those using Hims & Hers to access primary care services."

Streamlined digital healthcare services are more critical than ever as patients look to balance healthcare needs with social distancing considerations, and are key to expanding access to traditionally underserved communities. Alto is committed to ensuring affordable, timely access to medications and full-service pharmacy coverage, including specialty medications for the treatment of complex and chronic conditions.

Hims & Hers customers using Alto will get full access to Alto’s exceptional care and services: price investigation and automatic coupon application, easy access to chat with a pharmacist, medication reminders and other support tools, and the option to streamline all medications for the household into one easy delivery. Alto’s safe, secure courier delivery is always free.

Hims & Hers Partners with Alto for Same-Day Prescription Delivery for Primary Care Patients

Jaime Tolbert is a Patient Care Pharmacist based out of Alto’s Denver office. Here she shares what drew her to Alto and how the company is fulfilling its mission to be a better pharmacy.

Delivering the Best Care

Jaime Tolbert is a Patient Care Pharmacist based out of Alto’s Denver office. Here she shares what drew her to Alto and how the company is fulfilling its mission to be a better pharmacy. 

Prior to Alto, I worked in retail pharmacy for 13 years. My patients were the best part of my practice and helping them live healthier and happier lives was very fulfilling. When our company was bought out by CVS, there was a shift from caring about people and their health to a very task based environment. Spending the majority of my day on administrative work, being timed to finish each task, and not having time to really engage with my patients was devastating to me as a health care professional, and my work became less meaningful. One of my former colleagues had taken a position at Alto and shared how much she loved the company and its values. She offered to introduce me around and show me first hand what it was like to work here. I found that Alto puts their patients above all, and really cares about both the people they serve, and their employees. They are open to new ideas and changes, and really listen when you have thoughts and ideas about how to better serve our community or improve processes. 

Coming to Alto meant leaving behind my “family” of patients whom I loved and had worked with for years. Although this was a difficult decision, it is one I would make again in a heartbeat. This company is making a real change in pharmacy and in healthcare. After 6 months, I can honestly say I love to come to work, and I am so thankful every day for the opportunity to be part of something that is changing the face of healthcare. (And, as Alto expands our services in Denver, I am hopeful to bring many of those wonderful people to our company and offer them the personalized care they deserve.)

Working for Alto has brought me back to the reason that I became a pharmacist…to help people and to make a difference. My primary role is to focus on our patients- making sure they understand their medications, have a resource for information to answer all of their questions, and to give them the care that they deserve while keeping them safe from drug interactions or other medical issues. 

As patient care pharmacists, we are problem solvers, detectives, drug information resources, and caring providers of health and wellness to our patients. Regardless of what we do, we want to make sure we are acting in the best interest of the patient. There are instances in which people call in late at night with medication issues such as: their fertility medication has not been stored correctly and they need their injection right away, or their injection did not go as expected and they don’t know how to proceed. In these moments, we have to do some detective work and figure out if the drug is OK to use or not, or make judgement calls on the best course of action for these patients. It can be difficult to remain calm when patients are panicked or confused, but it’s our job to be a voice of reason, a sense of calm in the storm for the patient.

In the 13 years I spent in retail pharmacy, I wasn’t able to go nearly as in-depth with patient care as I do at Alto. In the retail setting, you perform all aspects of the job from start to finish mostly on your own, often within a strict time limit. At Alto, the company has separated the pharmacist role into two teams: a production team and a patient care team. The production pharmacists get to focus solely on medication preparation and inventory management while the patient care pharmacists can focus on patient consultations and clinical recommendations.

We definitely still try to work efficiently, but we have the luxury to take a 30-45 minute phone call to consult our patients and comfort them, if necessary. Some of the medications that we administer, like our fertility meds, can be really overwhelming. We have the benefit of taking time to walk patients through tough moments like their first injection, which is especially helpful on evenings and weekends when their doctor isn’t available.

Unlike the retail setting, all of Alto’s patient care interactions are done through phone calls, text messages, or secure message via our app. This model presents a lot of benefits including more privacy for the patient/pharmacist conversation.  Another benefit is the ability to reference those dialogues with the pharmacy in the event, for example, the patient forgets how the pharmacist advised to take the medication. The model also forces our team to really focus on every aspect of our messaging. We work hard to tailor both how we speak to patients and how we draft messages to ensure our patients feel a strong sense of empathy and can understand their instructions clearly. Our team also shares one voice. If a patient speaks with me about their defective medication on Tuesday, and that patient is then put in touch with one of my colleagues the following Wednesday, they will receive the same quality care and same customer service, and my colleague will have all of their most current information in detailed notes. 

Another unique factor about Alto is the team dynamic. There are 20 patient care pharmacists between the Denver and San Francisco offices. Working alongside other pharmacists every day, I’ve been able to learn so much about pharmacy that I didn’t know before. In a retail setting you're the lone individual making decisions and calls based on your interpretation of a situation.  Now, I have this entire team with varying perspectives to bounce ideas off of or go to for advice if something comes up that I have never dealt with before.

Our supervisors at Alto are also very skilled in identifying their employees’ strengths and inviting them to work on new projects. I really enjoy explaining things to people, so I’ve helped to re-write the training program for our patient care pharmacists; everything from surveys of how my team thinks we should train, to the training schedule, to physical training guides to help develop our new PCPs. That’s an opportunity I never would have had in traditional retail and I am grateful for the opportunity to help expand and train our team. I feel like working as a team is a great way to grow as a pharmacist, and ultimately benefits our patients which is why we are here.

Delivering the Best Care: Why a Veteran Pharmacist Chose to Join the Alto Team 

Alto’s expansion brings free daily doorstep delivery of medications to Seattle metro area residents

Starting Wednesday, April 15, residents of the Seattle metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

At Alto, we believe it’s our job to ensure you have your medications at the best price, on time and with the support you need. We bring pharmacy to you - no more waiting in line, making an extra trip, or finding out your prescription isn’t ready to be picked up after you’ve already arrived. Our free doorstep delivery means your medications come directly to you on the day and time you select, and most medications are available the same-day. Stay up to date on your courier’s progress with text alerts or in our mobile app. 

Starting a new medication or doing an injection for the first time? Message a pharmacist with your questions, even in the evenings and on weekends. And we’re a full service pharmacy - we stock all major brand, generic, over-the-counter and specialty medications, meaning your entire family’s pharmacy needs can be managed in the Alto app and coordinated into one delivery.

Monday - Friday: 6 – 9 pm PT
Saturday: 2 – 5 pm PT

Monday - Friday: 12:30 – 7 pm PT
Saturday: 10 am – 5 pm PT (closed on Sundays)
Please note that we are currently offering curbside pick-up only for walk-in business.

Seattle area residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). Have existing prescriptions at another pharmacy? Start a transfer online or give us a call at 1 (800) 874-5881, and we’ll handle the switch.

Blog

All about PrEP for HIV Prevention

What to Consider When Selecting a Fertility Pharmacy

The Best Pharmacy for Your Diabetes Care

Managing Your New Diabetes Diagnosis

Concerned about Mail Delays Tying up Your Prescriptions? There’s a Better Way.

How Alto Saves You Money on Prescriptions

What to Expect When You Interview as a Software Engineer at Alto

What is a Prior Authorization?

How to Manage Medication Side Effects

Hims & Hers Partners with Alto for Same-Day Prescription Delivery for Primary Care Patients

Delivering the Best Care: Why a Veteran Pharmacist Chose to Join the Alto Team

Seattle, Meet Alto

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