When your patient enrolls in the Program, INSUPPORT™ can provide the following services:
FULL HUB SERVICES
INSUPPORT™ will perform a Benefit Investigation of the patient's insurance coverage for PERSERIS, and/or obtain information on any associated prior authorizations (PA), appeals, and financial assistance. If applicable, INSUPPORT™ will also determine eligibility and enroll patient in the INSUPPORT™ Copay Assistance Program, or provide alternate sources of funding information, and/or route patient information and prescription to a pharmacy. Information for this service will be gathered based on the site of care indicated on the Patient Enrollment Form, either the prescriber's office or an alternate site of care which may include the PERSERIS Patient Injection Network (PIN). Please note, if site of care is a PERSERIS Patient Injection Network (PIN) location, specific information related to PA requirements may not be provided by INSUPPORT™ and may be provided by the PIN location.
INSURANCE VERIFICATION SERVICE ONLY
INSUPPORT™ will verify the patient's insurance coverage for PERSERIS and notify the HCP of the information provided by the patient's denied provider. If applicable, the final coverage for the product may be dependent upon the outcome of a prior authorization which must be performed by the provider office. Information for this service will be gathered based on the site of care indicated on the Patient Enrollment Form, either the prescriber's office or an alternate site of care which may include the PERSERIS Patient Injection Network (PIN). If the patient has commercial insurance and enrollment in the INSUPPORT™ Copay Assistance Program for PERSERIS is desired, the "Copay Assistance Program" service must be selected on the Patient Enrollment Form.
COPAY ASSISTANCE PROGRAM
Copay assistance is available for eligible privately insured patients to assist with the out-of-pocket cost of PERSERIS. Eligible patients who are enrolled may pay as little as $5 per injection of PERSERIS. Not all patients are eligible. Terms and Conditions apply.
ALTERNATE FUNDING RESEARCH
INSUPPORT™ will initiate research into alternate sources of funding for an uninsured or underinsured patient and provide the outcome of the research to the enrolling healthcare provider and to the patient, if requested.
DENIED CLAIM RESEARCH
INSUPPORT™ will initiate a review and research of a patient's denied claim. For this service, the Explanation of Benefits and a copy of the denial correspondence from the patient's health insurer is required in addition to a completed Patient Enrollment Form.
Receive information from a local Field Reimbursement Specialist (FRS) regarding your access and reimbursement questions.
Is an HCP practice required to use INSUPPORT™ to obtain access to PERSERIS for the patient?
No. This is an optional, free service offered by Indivior to support patient access.
Can an HCP practice conduct a benefit investigation?
Yes. An INSUPPORT™ benefit investigation contains detailed information on patient coverage for PERSERIS, as provided by the patient's insurance provider. However, if you prefer, you or your office staff can choose to conduct the benefit investigation yourself.
When is it necessary to obtain the patient's signature on the Patient Authorization and Consent Form?
INSUPPORT™ cannot take any action until a written or electronic patient signature has been obtained for the following services: Full Hub Services, Copay Assistance Program, and Alternate Funding Research.
Any Patient Enrollment Form requesting these services without a signed and dated Patient Authorization and Consent, submitted via fax or the INSUPPORT™ Provider Portal, will be returned to the HCP for the patient's signature and signature date. Please note INSUPPORT™ cannot contact the patient directly to obtain authorization and consent if one is not already on file.
The following services offered by INSUPPORT™ do not require a signed and dated Patient Authorization and Consent: Insurance Verification Only and Denied Claim Research.
Can a patient be enrolled in INSUPPORT™ services online?
A patient's healthcare provider can enroll a patient online by visiting the INSUPPORT™ Provider Portal and completing the required steps for enrollment for the requested services. If required for the requested service, a signed and dated Patient Authorization and Consent form must be uploaded even when enrolling a patient in INSUPPORT™ services electronically via the INSUPPORT™ Provider Portal.
What if the patient's insurance provider does not provide coverage for PERSERIS?
If a medication is not covered by the patient's insurance provider or coverage is "Undetermined", there may be steps that you can take to request that the insurance provider re-evaluate the patient's coverage decision. You may contact the patient's insurance provider for more information.
Complete a Letter of Medical Necessity
You or your office staff may complete a Letter of Medical Necessity to provide further information about the patient and request coverage for PERSERIS.
View a Sample Letter of Medical NecessityDOWNLOAD PDF
Alternate Funding Research
INSUPPORT™ may also be able to provide contact information on potential alternate funding programs for which the patient may qualify. The patient will be responsible for contacting the programs to determine their eligibility and funds available, if applicable.
Alternate Funding Research is included as part of the benefit investigation for patients enrolled in Full Hub Services or can be requested at any time as a stand-alone service by selecting "Alternate Funding Research" on page two of the Patient Enrollment Form.