Available support / Patient and practice support

Potential support
available to patients and practices

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Many manufacturers may have patient support programs to help patients gain access to therapy after the drug has been prescribed. Below are some examples of potential support. Contact the applicable manufacturer for further information.

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Claims and reimbursement support

  • Benefits investigation and PA support, including appeals and medical exceptions

  • Information on current coverage policies and step edit requirements

  • Up-to-date billing and coding information (including relevant coding information for EHR updates)

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Patient support

  • Patient affordability programs for assistance with drug costs for eligible patients

Patient support programs may offer support for access and reimbursement, but the availability and scope of programs varies. These programs also function within limits, which may include restrictions prohibiting actions such as:

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  • Making any guarantee of insurance coverage or reimbursement

  • Filling out forms (service requests forms [SRFs], claims, appeals letters, etc)

  • Discussing buy-and-bill margins

  • Recommending specific infusion sites or locations

  • Recommending the use of any specific EHR system or vendor