Brandi, treated with Acthar Gel.
Individual results
may vary. Compensated by Keenova.
You're an essential member of a patient's care team.
Start the process by sending the Enrollment/Prescription
Form to:
Fax: 877-937-2284
Email:
intake@supportandaccess.com
If you are calling about a specific patient case, please contact the HUB at 1-888-435-2284.
Monday - Friday, 8 AM to 9
PM ET
Saturday, 9 AM to
2 PM ET
If you have reimbursement and access questions, please reach out to your Access and Reimbursement Manager.
Your Sales Representative can connect you with an Access and Reimbursement Manager. If you're already connected with a sales representative, they're here to help. If not, you can request one here.
Learn how our dedicated team can work with your office throughout the approval process.
To get started with the prescription and reimbursement process, download the relevant form.
See a full directory and learn more about enhanced services and support offerings from specialty pharmacies.
Share this resource to help patients understand simple steps they can take to get Acthar Gel once it has been prescribed to them.
Get a checklist of specific paperwork and tasks required for prior authorization and appeal processes for Acthar Gel.
Download a Letter of Medical Necessity template, including sample language you can customize when responding to an insurance denial on behalf of a patient.
Let patients know! Acthar Patient Support will send tools to help them through the process. They simply need to:
A Case Manager may also contact your office if there are
questions.
Responding
promptly can ensure patients get Acthar Gel as soon as
possible.
Have a question?
1-888-435-2284
Monday - Friday, 8 AM to 9
PM ET
Saturday, 9
AM to 2 PM ET
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