COVERAGE & REIMBURSEMENT SUPPORT FOR RENFLEXIS
The Organon Access Program can help you understand the benefits investigation, prior authorization, and appeal process.
The Organon Access Program can contact insurers to request patient-specific coverage and benefits information for RENFLEXIS, including:
- whether the plan covers RENFLEXIS;
- deductible, coinsurance, and out-of-pocket maximum amounts; and
- whether the plan has prior authorization or step therapy requirements.
Getting started is simple
For patient-specific coverage questions
- Download and complete the appropriate sections of the enrollment form, OR use the electronic enrollment form via CoverMyMeds.
- If your patient is eligible and interested in co-pay assistance or the Organon Patient Assistance Program, please have the patient fill out the appropriate sections.
- Submit electronically, or print and fax the completed downloadable form to 800-376-2580.
- A program representative will contact your patient and your office.
If a prior authorization is required, for assistance in understanding if a prior authorization is required, or if a prior authorization request has been denied, The Organon Access Program may be able to help.
The provided prior authorization checklist and prior authorization sample letter can help you to understand the documents and what information may be required by a payer when seeking a prior authorization.
Getting started is simple
For patient-specific coverage questions
- Download and complete the appropriate sections of the enrollment form, OR use the electronic enrollment form via CoverMyMeds.
- If your patient is eligible and interested in co-pay assistance or the Organon Patient Assistance Program, please have the patient fill out the appropriate sections.
- Submit electronically, or print and fax the completed downloadable form to 800-376-2580.
- A program representative will contact your patient and your office.
If you have submitted a claim and the claim has been denied, you can submit an appeal to your patient’s insurer.
The Organon Access Program may be able to help your office understand the information needed for an appeal submission.
The provided appeal checklist and sample letter can help you to understand the documents and what information may be required by a payer when filing an appeal. As always, you should check for payer-specific requirements.
Getting started is simple
For patient-specific coverage questions
- Download and complete the appropriate sections of the enrollment form, OR use the electronic enrollment form via CoverMyMeds.
- If your patient is eligible and interested in co-pay assistance or the Organon Patient Assistance Program, please have the patient fill out the appropriate sections.
- Submit electronically, or print and fax the completed downloadable form to 800-376-2580.
- A program representative will contact your patient and your office.
The information available here is compiled from sources believed to be accurate, but Organon makes no representation that it is accurate. This information is subject to change. Payer coding requirements may vary or change over time, so it is important to regularly check with each payer as to payer-specific requirements.
The information available here is not intended to be definitive or exhaustive, and is not intended to replace the guidance of a qualified professional advisor. Organon and its agents make no warranties or guarantees, express or implied, concerning the accuracy or appropriateness of this information for your particular use given the frequent changes in public and private payer billing. The use of this information does not guarantee payment or that any payment received will cover your costs.
You are solely responsible for determining the appropriate codes and for any action you take in billing. Information about HCPCS codes is based on guidance issued by the Centers for Medicare & Medicaid Services applicable to Medicare Part B and may not apply to other public or private payers. Consult the relevant manual and/or other guidelines for a description of each code to determine the appropriateness of a particular code and for information on additional codes. Diagnosis codes should be selected only by a health care professional.
HCPCS, Healthcare Common Procedure Coding Systems.