When Dr. Stephen Lewellis launched Above and Beyond Dermatology in Wisconsin, he set out to build something different: a modern, patient-centered dermatology practice that prioritized thoughtful care over volume. As a board-certified and integrative dermatologist, he wanted to give patients more time, more attention, and a better experience than the standard fast-paced clinic model allowed.

Launching a solo practice, however, came with the same administrative hurdles faced by large health systems—especially around prior authorizations, appeals, and pharmacy coordination. Without staff to handle that work, every prescription meant hours of paperwork. To stay lean and scalable from day one, Dr. Lewellis turned to Tandem to automate the administrative burden of patient access.

The Challenge: Independent Dermatology Still Has Big-Clinic Paperwork

Running a single-provider dermatology practice does not mean having a lighter administrative load. Every biologic has a unique enrollment process. PBMs still depend on fax machines. Bridge and patient-assistance programs all require separate forms and follow-ups.

For Dr. Lewellis’ new practice, that workload fell entirely on him. Each biologic prescription meant hours of printing, scanning, chasing signatures, and coordinating with insurance representatives.

“I could spend two hours on a single biologic in a day if it required all of that [paperwork].”

That volume of administrative work was not sustainable for a one-man practice. Hiring a biologic coordinator would have doubled early overhead before revenue stabilized, but doing everything manually took valuable time away from patients.

“It is scary to hire people to do these types of things when you are already not really paying yourself or hardly keeping the lights on.”

Independent dermatologists face the same regulatory requirements as hospital systems, but without the infrastructure to absorb them. Dr. Lewellis needed a solution that could manage the heavy lifting of patient access without adding to his cost structure.

Finding a Fit for Entrepreneurial Practices

When Dr. Lewellis first heard about Tandem, he immediately recognized it as the kind of platform he had been hoping someone would build: an automated patient-access solution that handles prior authorizations, appeals, and manufacturer enrollments on behalf of the practice, and does so at no cost to the provider.

He saw in Tandem not just a time-saving tool, but an enabler for the next generation of independent physicians who want to build innovative, scalable practices.

“When I heard about Tandem, it was everything I thought I would eventually see in this market in terms of taking the biologic coordination off of our books, especially for a small, independent practice like mine.”

By shifting this work to Tandem, he could stay focused on the patient experience and use technology to operate like a much larger organization without the administrative burden.

Before and After Tandem

Implementation was quick and seamless. Within a few days of completing onboarding, Dr. Lewellis was ready to send his first prescriptions through Tandem. Once active, the impact on daily operations was immediate.

“Most patients are really happy to be able to click a link and fill it out digitally. That is what we are used to.”

Before Tandem

• Track every fax manually and follow up with PBMs for each patient

• Print, scan, and fax enrollment and bridge program forms

• Call patients directly for signatures and updates

• Keep binders for each medication’s access process

• Lose valuable time to paperwork and missed calls

After Tandem

• Prescribe and send to Tandem as the default destination for access support

• Tandem texts patients, collects digital signatures, submits PAs, and drafts appeals automatically

• The physician only steps in to upload clinical notes or make final approvals

• Everything is tracked digitally, eliminating binders, phone tag, and duplicate data entry

• Prescriptions move faster, with patients fully informed throughout the process

Dr. Lewellis estimates that Tandem saves him five to ten times the amount of time he used to spend managing biologic prescriptions. That efficiency gave him the ability to grow the practice, add new patients, and invest in content creation like his podcast.

The Impact: Freedom to Build and Grow

With Tandem handling the access burden, Dr. Lewellis could return his attention to the reasons he went independent in the first place: patient care, innovation, and education. He continues to expand his reach through his dermatology podcast, which has become a platform for discussing both clinical and business aspects of modern dermatology.

For other entrepreneurial physicians, his experience highlights how technology can remove the friction that prevents small practices from competing with large networks. Tandem made it possible for a solo dermatologist to launch and operate efficiently from day one, while still offering biologics and complex therapies that typically require dedicated support staff.

“Small fish can become, if given the right tools, very, very big fish.”