Thursday, January 1, 2009

Pharmaceuticals and Biologicals by Company F-K

Genentech Reimbursement Hotline
Monday–Friday, 8 am–5 pm, PST

Reimbursement specialists provide information, counseling, and hands-on assistance for problems with reimbursement for Genentech products: Activase® (alteplase, recombinant), Avastin™ (bevacizumab), Herceptin® (Trastuzamab), Nutropin® [somatropin (r DNA origin) for injection], Nutropin AQ® (somatrem for injection), Nutropin AQ Pen ™ Cartridge [somatropin (r DNA origin) injection], Rituxan ™ (Rituximab), Tarceva® (erlotinib). Information regarding Genentech Access to Care Foundation, established to provide medically indicated products to patients who are uninsured and have limited financial resources, is also provided.

Avastin Patient Assistance Program
Single Point of Contact (SPOC)
Monday–Friday, 6 am–5 pm PST
Phone: 888.249.4918
Fax: 888.249.4919

The Avastin Patient Assistance Program is designed to limit the overall annual cost of Avastin for eligible patients receiving treatment for FDA-approved indications. Participation in the program provides a voluntary opportunity for physicians and eligible patients who reach an annual charge of 10,000 mg to receive free Avastin from Genentech for the remainder of the 12-month period. The program is open to all patients receiving Avastin (regardless of insurance coverage) with a household adjusted gross income of up to $100,000. Patients must be receiving Avastin for an FDA-approved indication.

Single Point of Contact (SPOC)
Monday–Friday, 6 am–5 pm PST
Phone: 888.249.4918
Fax: 888.249.4919

Genentech BioOncology's SPOC provides timely, one-step reimbursement assistance. Oncology case managers will assist callers by: investigating benefits for new patients and those changing insurance or facing open enrollment, assisting with prior authorizations, helping with appeals and coverage denials, searching for alternative coverage for patients, answering questions related to product reimbursement, and consulting on coding/billing issues. Financial services include uninsured patient programs.

Now available: information about co-pay assistance through independent public charities.

Gilead Reimbursement Support & Assistance Program
Monday–Friday, 9 am–5 pm, EST

The Gilead Reimbursement Support & Assistance Program is a service staffed by representatives trained to answer questions concerning coverage and reimbursement for Viread® (tenofovir) DaunoXome® (daunorubicin citrate liposome injection) and Vistide® (cidofovir injection). The program offers a range of reimbursement support services including: contacting insurance companies to determine a patient’s coverage; researching information about insurers’ coverage policies for these products; educating third-party payers; assisting with prior authorization procedures and other ways to expedite reimbursement; providing information on billing codes and claims filing processes; helping to resolve denied claims; and assistance with appeals. The program may provide Viread Daunoxome and/or Vistide to patients who: do not have health insurance or do not qualify for government assistance programs, and meet the program’s financial criteria. Patients or providers may contact the program at (800) 226-2056 for additional information.

Glaxo Smith Kline

GSK Reimbursement Resource Center
Monday–Friday, 9 am– 6 pm, ET
Phone: 800.745.2967 or 800.699.3806
Fax: 866.216.5292

The GSK Reimbursement Resource Center is available to assist patients and healthcare professionals with coverage, coding and, reimbursement issues for over 50 GlaxoSmithKline products, including the following oncology products:

ARRANON® (nelarabine) Injection, BEXXAR® (Tositumomab and Iodine I 131 Tositumomab), HYCAMTIN® (topotecan Hcl), LEUKERAN® (chlorambucil), MYLERAN® (busulfan), TABLOID® brand Thioguanine, TYKERB® (lapatinib) and ZOFRAN® (ondansetron HCl).

Available services:
Verification of benefits/payer research
Denied/underpaid claims assistance
Prior authorization assistance
Coding and billing assistance
Alternate funding searches

Commitment to Access
Patients who have been prescribed TYKERB and have no insurance coverage may be eligible to receive TYKERB free of charge if they live in one of the 50 states or the District of Columbia and their income is at or below 500 percent of the federal poverty level (For example, $68,450 for a household of two. Income eligibility is adjusted for household size). For patients enrolled in a Medicare Part D plan, eligibility also requires documentation of $600 in expenditures on prescription medicines in the current calendar year. Patients who are eligible for Medicare and who have incomes below 135 percent of the federal poverty level may not be eligible for GSK's patient assistance programs if they qualify for full assistance under Medicare.

More information regarding Commitment to Access is available at and by calling 1-866-475-3678.

Guilford Pharmaceuticals

Guilford CaRe (SM) Program
Monday–Friday, 9 am–5 pm, EST
877.90.WAFER (1.877.909.2337)

Guilford Pharmaceuticals offers the Guilford CaRe (SM) Program, a comprehensive case management program free of charge to patients, caregivers, medical billing staff at physicians’ offices and hospitals, to health care providers, and others with questions about insurance coverage, coding, and reimbursement for the GLIADEL® Wafer and related procedures. The program takes a case management approach to solving third-party product reimbursement questions. Through the CaRe(SM) Program, Guilford provides the GLIADEL® Wafer Reimbursement Hotline and the PAL(SM) (Patient Assistance Link) Program, which provides free replacement product to institutions for patients that meet eligibility criteria. Trained reimbursement associates are available to provide assistance in several areas including: billing and coding, insurance verification, prior authorization support, insurer education, policy monitoring, and claims appeals.

ImClone Systems Incorporated

Destination Access
Monday–Friday, 7:00 am–7:00 pm, CST
Phone: 800.861.0048
Fax: 888.761.2370

The service is designed to assist callers from the medical community with reimbursement issues surrounding Erbitux and all of ImClone System's products. The hotline is staffed by trained reimbursement specialists who will provide information on third-party coverage guidelines, claim requirements of individual third-party payers, limitations of specific policies, drug and procedures coding, and names and addresses of third-party payers. The hotline offers assistance in providing details on claim form submission, identifying reasons for claim rejection, providing guidelines and literature for claim appeals, facilitating prior authorization requests, and contacting insurers when appropriate in the process of claim submission. The hotline is designed for providers in the United States.

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