Asthma and Allergy Affiliates Wiki

You've loaded an old revision of the document! If you save it, you will create a new version with this data.

====== Prior Authorizations ======

----
Medicaid based plans (MGB ACO, Wellsense, MassHealth) do not seem to cover patanase nasal spray.

In office admin through buy & bill- Healix completes PA (buy & bill is required by Medicare but no PA required if medical criteria is met)

Medications obtained through pharmacy benefits- KK2 completes PA (CoverMyMeds, PromptPA, MBG/ Optum portal, paper forms)

Commercial insurances (MGB, BCBS, HP, etc.) require PA's for all biologics and specialty medications. Most are now covering Neffy.

The in office sales reps and reimbursement managers do not speak with patients directly. All of the reps have just advised patients reach out to the companies through their customer support lines for any financial questions.
1-866-4XOLAIR (1-866-496-5247)
1-844-4NUCALA (1-844-468-2252)
1-888-TZSPIRE (1-888-897-7473)
Fasenra: 1-833-360-HELP(4357)

Direct contact for patient help for Dupixent:
Vanessa Saesee, Dupixent MyWay Case Manager Office: 1-844-DUPIXENT (1-844-387-4936) ext. 15764

Optum- direct # for providers: 855-215-0235

Optum Specialty contact:
Alex- 224-231-1657

Edit summary