COTELLIC and ZELBORAF Coverage
Benefits Investigation
Why is a benefits investigation important?
Genentech BioOncology Access Solutions for COTELLIC and ZELBORAF
conducts a benefits investigation (BI) to help you better understand
your patient's health insurance plan coverage for the costs associated
with treatment. The BI can also determine if a prior authorization
(PA) or patient assistance might be needed.
There are 3 possible outcomes of a BI:
- Treatment is covered
- PA is required
- Treatment is denied
To begin with Genentech BioOncology Access Solutions, you must
complete and submit a Statement of Medical Necessity (SMN) form and
have your patient complete and submit a Patient Authorization and
Notice of Release of Information (PAN) form. To request a BI, be sure
to check the appropriate box on the SMN.
The SMN can be submitted online via My Patient Solutions™ or downloaded from Forms and Documents.
Patients can access the PAN through Forms and Documents or submit the PAN online here.
This description of a BI is for informational purposes only.
Genentech BioOncology Access Solutions makes no representation or
guarantee concerning reimbursement or coverage for any service or item.
Prior Authorization
Genentech BioOncology Access Solutions for COTELLIC and ZELBORAF can
help your practice identify if a prior authorization (PA) is needed
and offer support as you obtain it for your patient. All we need to
begin are a completed and signed Statement of Medical Necessity (SMN)
form requesting our assistance with the PA as well as a signed and
dated Patient Authorization and Notice of Release of Information (PAN)
form.
Genentech BioOncology Access Solutions can help you as you submit the required PA forms and documentation. If the PA is not granted, Genentech BioOncology Access Solutions can work with you to determine your next steps. Tips like this can be found in Forms and Documents.
Latest Updates
Form:
Statement of Medical Necessity (SMN)
Form:
Patient Authorization and Notice of Release of Information (PAN)