The process and paperwork related to insurance coverage can be daunting. If your patients need support, Pfizer Oncology Together is here to help.
We can conduct a benefits verification to determine a patient's health insurance coverage and out-of-pocket costs. After verifying coverage, we'll provide a summary of benefits for oral and injectable medications:
We’ll coordinate with a patient’s insurer to determine the PA requirements, where and how to submit requests, and typical turnaround times. After your office submits a PA request, we’ll follow up with the insurer on behalf of the patient to track the progress and status, upon your request.
Below are sample templates and checklists that may be helpful in cases where additional information is required by the insurer.
Sample Letter of Medical NecessityDownload
Letter of Medical Necessity ChecklistDownload
Prior Authorization ChecklistDownload
PfizerOncologyPortal.com provides 24/7 access to helpful resources and information where registered users can:
Find sample letters, checklists, and other insurance support resources on the Forms & Resources page.Explore Resources
To help your patients access the medication you've prescribed, we can identify specialty pharmacy options. If you prefer, you and your staff can also continue to work directly with specialty pharmacies.
BESPONSA® (inotuzumab ozogamicin) and MYLOTARG™ (gemtuzumab ozogamicin) are available through a network of specialty distributors and specialty pharmacies.
Injectable biosimilars are available through most major wholesalers.
For your patient's claims submissions, we provide easy access to sample forms and template letters, along with billing and coding information for physician’s office and hospital outpatient settings of care.*
ZIRABEV™ (bevacizumab-bvzr) Billing & Coding Guide
MYLOTARG Sample CMS-1500 Form For Physician Office Use
The sample forms are intended as a reference for billing and coding of BESPONSA, MYLOTARG, ZIRABEV, RUXIENCE, TRAZIMERA, RETACRIT, and NIVESTYM. These forms are not intended to be directive or to replace clinical decision-making, and the use of the recommended codes does not guarantee reimbursement. Healthcare providers may deem other codes or policies more appropriate and should select the coding options that most accurately reflect their internal guidelines, payer requirements, practice requirements, practice patients, and the services rendered.
If you have questions about a specific Pfizer Oncology product, a Pfizer Oncology Account Specialist can help provide detailed information—in your office or over the phone.
Find a Pfizer Oncology Account Specialist in your area:
Please see full Prescribing Information for BESPONSA (inotuzumab ozogamicin), including BOXED WARNING, or visit BESPONSAhcp.com.
Please see full Prescribing Information for DAURISMO (glasdegib), including BOXED WARNING and Medication Guide, or visit DAURISMOhcp.com.
Please see full Prescribing Information for MYLOTARG (gemtuzumab ozogamicin), including BOXED WARNING, or visit MYLOTARGhcp.com.
Please see full Prescribing Information for RETACRIT (epoetin alfa-epbx), including BOXED WARNING and Medication Guide, or visit RETACRIThcp.com.
Please see full Prescribing Information for RUXIENCE (rituximab-pvvr), including BOXED WARNING and Medication Guide, or visit RUXIENCEhcp.com.
Please see full Prescribing Information for SUTENT (sunitinib malate), including BOXED WARNING and Medication Guide, or visit SUTENThcp.com.
Please see full Prescribing Information for TRAZIMERA (trastuzumab-qyyp), including BOXED WARNING, or visit TRAZIMERAhcp.com.