Herceptin Hylecta Coverage
Benefits Investigations
Herceptin Hylecta Access Solutions can conduct a benefits
investigation (BI) to help you determine if a Genentech medicine is
covered, if prior authorizations (PAs) are required, which specialty
pharmacy (SP) the health insurance plan prefers and if patient
assistance might be needed.
Potential outcomes of a BI:
- Treatment is covered
- PA is required
- Treatment is denied
Both the Prescriber Service Form and the Patient Consent Form must
be received before Herceptin Hylecta Access Solutions can begin
helping your patient.
These can be downloaded from Forms and Documents or submitted online via My Patient Solutions.
The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and health care provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.
Prior Authorization
Herceptin Hylecta Access Solutions can help you identify if a prior
authorization (PA) is necessary and offer resources as you obtain it
for your patient. Both the Prescriber Service Form and the Patient
Consent Form must be received before Herceptin Hylecta Access
Solutions can begin helping your patient.
If your patient’s request for a PA is not granted, your BioOncology Field Reimbursement Manager (BFRM) or Herceptin Hylecta Access Solutions Specialist can work with you to determine your next steps. You can find more tips like this in Forms and Documents.
The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and health care provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.
