Completing a PA
Some insurance providers may require a PA to grant a patient coverage for SUBLOCADE® (buprenorphine extended-release) injection, for subcutaneous use (CIII).
INSUPPORT can provide information on the PA process and/or PA requirements from a patient's insurance provider, when applicable.
For patients enrolled in Transition of Care Support, PA requirements for the new provider are detailed on the Final Benefit Summary.
Is a PA required?
Step 1: Review the PA Requirements
When applicable, INSUPPORT can provide insurer PA requirements to a healthcare provider (HCP) office. The patient's HCP must complete and submit any required PA form(s) to the patient's insurance provider.
Once the required PA forms and/or documentation are submitted to the patient's insurance provider, INSUPPORT can check the status of the PA request until an outcome is determined by the patient's insurance provider.
*This annotated sample is intended for informational purposes only and not for direct use as a Benefit Summary.
Do I have to renew a PA once the patient's health insurance plan has approved it?
Often, insurance providers require re-authorization for the patient after a certain period of time. If the patient is enrolled in "Benefit Coverage Information" with INSUPPORT, INSUPPORT will notify you 21 days in advance of expiry of the current authorization and provide re-authorization requirements communicated by the patient's insurance provider. If the patient is not enrolled in INSUPPORT, you may contact the patient's health insurance provider for information about re-authorization requirements.
Is there any additional information that the health insurance provider may require to determine a PA for the patient?
Each health insurance plan has its own PA requirements. If the patient is enrolled in "Benefit Coverage Information" with INSUPPORT, INSUPPORT will inform you of any requirements communicated by the patient's insurance provider on the Preliminary Benefit Summary. If the patient is not enrolled in INSUPPORT, you may contact the patient's health insurance provider for information about PA requirements.