XELODA Coverage
Benefits Investigations
Genentech BioOncology® Access Solutions for XELODA 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 Genentech BioOncology Access Solutions can begin helping your patient.
These can be downloaded from Forms and Documents or submitted online via My Patient Solutions.
Prior Authorization
Genentech BioOncology® Access Solutions for XELODA 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 Genentech BioOncology 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 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 makes no representation or guarantee concerning
coverage or reimbursement for any service or item.
