WELCOME TO

THE ORGANON ACCESS PROGRAM

ARE YOU A US HEALTH CARE PROFESSIONAL?
The Organon Access Program for RENFLEXIS® (infliximab-abda)
RENFLEXIS® (infliximab-abda) for injection, for intravenous use 100 mg
Physician Prescribing Information Medication Guide
Health Care Professionals Patients and Caregivers
Medication Guide Physician Prescribing Information
The Organon Access Program for RENFLEXIS® (infliximab-abda)
Before prescribing RENFLEXIS, please read
the accompanying Prescribing Information, including the Boxed Warning about serious infections and malignancies.
The Medication Guide also is available.
RENFLEXIS® (infliximab-abda) for injection, for intravenous use 100 mg
MENU
  • ENROLL NOW
  • Home for The Organon Access Program for RENFLEXIS® (infliximab-abda)
  • Home
  • Coding & Billing
  • Coverage &
    Reimbursement Support
  • Financial Assistance
    • The Organon Co-pay Assistance Program
    • The Organon Patient Assistance Program
    • Co-pay Claims Portal
  • Resources
ENROLL NOW
Contact The Organon
Access Program at 866-847-3539
Mon-Fri 8 AM to 8 PM ET

ENROLL NOW WITH
3 OPTIONS

Please review the 3 options below to access The Organon Access Program and choose the method that best works for you and your patient. If your patient is requesting a referral to the Organon Patient Assistance Program, be sure to include all information, including a prescription for RENFLEXIS. Please be sure all signatures are included prior to submitting forms to The Organon Access Program.

Option
1

Electronic Enrollment
via CoverMyMeds

Click to enroll

Allows providers to electronically enroll patients into
The Organon Access Program and initiate other access services.

With CoverMyMeds, you can:

  • Perform benefits investigations and submit prior authorizations
  • Access the Organon Co-pay Assistance Program
  • Track patient case status
  • Submit prescriptions

Option
2

Electronic Enrollment
via Docusign

FOR PATIENT IN OFFICE

2023 ELECTRONIC
ENROLLMENT FORM

FOR PATIENT NOT IN OFFICE

2023 ELECTRONIC
Health Care Provider
Enrollment form

These forms can be signed and submitted electronically via DocuSign.

Option
3

Download,
Print & Fax

2023 ENROLLMENT FORM

Download this form to fill out, print, and fax.

2023 Sample
ENROLLMENT FORM

ENROLLMENT ASSISTANCE

Use this form as a guide for completing the enrollment form.

Option 1

Electronic Enrollment
via CoverMyMeds

Click to enroll

Allows providers to electronically enroll patients into
The Organon Access Program and initiate other access services.

With CoverMyMeds, you can:

  • Perform benefits investigations and submit prior authorizations
  • Access the Organon Co-pay Assistance Program
  • Track patient case status
  • Submit prescriptions

Option 2

Electronic Enrollment
via Docusign

FOR PATIENT IN OFFICE

2023 ELECTRONIC
ENROLLMENT FORM

FOR PATIENT NOT IN OFFICE

2023 ELECTRONIC Health Care
Provider Enrollment form

These forms can be signed and submitted
electronically via DocuSign.

Option 3

Download, Print & Fax

DOWNLOAD THE 2023
ENROLLMENT FORM

Download this form to fill out, print, and fax.

ENROLLMENT ASSISTANCE

2023 SAMPLE
ENROLLMENT FORM

Use this form as a guide for completing the
enrollment form.

This site is intended only for residents of the United States.
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You will be navigating to a website outside of
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