RITUXAN HYCELA Coverage
Benefits Investigations
Genentech BioOncology® Access Solutions for RITUXAN HYCELA can
conduct a benefits investigation (BI) to help you determine if RITUXAN
HYCELA 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
A BI may be initiated once the SMN and PAN are submitted to
Genentech BioOncology Access Solutions.
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 and Biogen make no representation or guarantee
concerning coverage or reimbursement for any service or item.
Prior Authorization
Genentech BioOncology® Access Solutions for RITUXAN HYCELA can help
you identify if a prior authorization (PA) is necessary and offer
resources as you obtain it for your patient. PA support may be
provided once the SMN and PAN are submitted to Genentech BioOncology
Access Solutions.
If your patient’s request for a PA is not granted, your BioOncology Field Reimbursement Manager (BFRM) or Genentech BioOncology 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 and Biogen make no representation or guarantee concerning coverage or reimbursement for any service or item.
PAN=Patient Authorization and Notice of Request
for Transmission of Health Information to Genentech Access Solutions
and Genentech® Access to Care Foundation.
SMN=Statement of Medical Necessity.