Navigating access and reimbursement. Together.
If patients need access or reimbursement support for their prescribed Pfizer Oncology medications, we’re here to help.
Insurance Support
BENEFITS VERIFICATION
We can conduct a benefits verification to determine a patient’s health insurance coverage and out-of-pocket costs.
PRIOR AUTHORIZATIONS (PA)
We can coordinate with a patient’s insurer to determine the PA requirements, where and how to submit requests, and typical turnaround times. After a PA request is submitted, we’ll follow up with the payer on behalf of the patient—to track the progress of the request until a final outcome is determined.
APPEALS ASSISTANCE
If a patient’s claim is denied, we can review the reason for the denial and provide information on payer requirements. Once the appeal is submitted, we can follow up with the payer to track the progress of the request until a final outcome is determined.
Specialty Pharmacy Coordination
To help 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.
IV products are also available through a network of specialty distributors.
VIEW SPECIALTY PHARMACIES AND DISTRIBUTORS
IV Products
BILLING AND CODING ASSISTANCE
For your patient claim submissions for BESPONSA® (inotuzumab ozogamicin) or MYLOTARG™ (gemtuzumab ozogamicin), 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.*
- BESPONSA SAMPLE UB-04/CMS-1450 FORM FOR HOSPITAL OUTPATIENT USE
- BESPONSA SAMPLE CMS-1500 FORM FOR PHYSICIAN OFFICE USE
- MYLOTARG SAMPLE UB-04/CMS-1450 FORM FOR HOSPITAL OUTPATIENT USE
- MYLOTARG SAMPLE CMS-1500 FORM FOR PHYSICIAN OFFICE USE
ORDERING IV PRODUCTS
BESPONSA and MYLOTARG are available through a network of specialty distributors and one specialty pharmacy.
Please see full Prescribing Information for BESPONSA, including BOXED WARNING for hepatotoxicity, including VOD, and increased risk of post-HSCT non-relapse mortality, or visit BESPONSAhcp.com.
Please see full Prescribing Information for MYLOTARG, including BOXED WARNING for hepatotoxicity, or visit MYLOTARGhcp.com.
*The information provided here is intended for informational purposes only, and is not a comprehensive description of potential coding requirements for BESPONSA and MYLOTARG. Coding and coverage policies change periodically and often without warning. The healthcare provider is solely responsible for determining coverage and reimbursement parameters and accurate and appropriate coding for treatment of his/her own patients. The information provided in this section should not be considered a guarantee of coverage or reimbursement for BESPONSA and MYLOTARG.
Dedicated Local Support
FOR PRODUCT SUPPORT
If you have questions about a specific Pfizer Oncology product, a Pfizer Oncology Account Specialist can help. He or she is available to provide detailed information—in your office or over the phone.
