Reimbursement assistance and support
Cephalon Oncology is committed to supporting patients and healthcare providers. We
go further to
provide you with convenient resources that make reimbursement easier to understand. These
services are offered through a reimbursement support program called
CORE (Cephalon Oncology
Reimbursement Expertise).
CORE information resources can be accessed online or with personalized support via a toll-free
hotline. Both CORE resources are designed to help clarify the issues and facilitate the processes
involved when submitting reimbursement claims.
CORE Hotline
Phone: 1-866-261-7730
Fax: 1-888-891-4924
Visit the CORE website
www.CephalonOncologyCORE.com
CORE Patient Enrollment Form
>> Click here to download the Patient Enrollment Form and get your patient started in CORE.
Reimbursement Fact Sheet
The product and reimbursement fact sheet for TRISENOX® (arsenic trioxide) injection includes
information necessary for reimbursement purposes: strength/size of the drug, unit of sale,
NDC number, storage requirements, HCPCS code, wholesale acquisition cost (WAC) and Q4 2005
Medicare payment rate.
>> Click here to download the Reimbursement Fact Sheet.
The CORE website contains information and downloadable forms to help you access what you need
to clarify billing issues, policy benefits, coverage requirements, and appeals.
At
www.CephalonOncologyCORE.com, you have access to:
- Reimbursement FAQs
- Required forms in downloadable/printable formats
- Appeal assistance
- Sample letters and reference documents
- Definitions of payor plans and reimbursement terminology
CORE reimbursement consultants are available by phone Monday through Friday, from
9 am to 8 pm Eastern Time. They can help with the following:
- Benefit verification and coverage
- Policy benefits and limitations
- Pre-certifications
- Drug and services coding information
- Coverage guidelines and claim requirements of payors
- Support throughout the entire claims process
- Requested information needed to support claims submission
- Appeal support
When calling about patient-specific reimbursement issues, it will be helpful to have the
following available:
- Patient's name, address, telephone number, date of birth, social security number, diagnosis, therapy start date, and expected course of treatment (CORE is a HIPAA compliant service)
- Name and telephone number of payor plan(s), policy number(s) and name of subscriber
- Physician's name, address, and telephone number
For coverage verifications and prior authorization or appeal support, patients will need to
review and sign the enrollment form and fax or mail it to the CORE Hotline.
>> Click here to download the Patient Enrollment Form.
Cephalon does not formally make appeals for callers, nor does it guarantee success in obtaining
insurance authorizations or payments. Third-party payment for medical products and services is
affected by numerous factors, not all of which can be anticipated or resolved by the CORE Hotline
staff.