Why is a benefits investigation important?
Erivedge Access Solutions 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
There are 3 possible outcomes of a BI:
- Treatment is covered
- PA is required
- Treatment is denied
To begin with Erivedge 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.
This description of a BI is for informational purposes only.
Erivedge Access Solutions makes no representation or guarantee
concerning reimbursement or coverage for any service or item.
Erivedge Access Solutions 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.
Erivedge Access Solutions can help you as you submit the required PA forms and documentation. If the PA is not granted, Erivedge Access Solutions can work with you to determine your next steps. Tips like this can be found in Forms and Documents.