Our Case Managers can Help Your Patients Explore Options and Access Treatment

Our Case Managers are available to support providers, patients and caregivers with 1:1 assistance

PTx Assist provides the following services:

Conduct Benefit Verifications

  • Confirm and summarize insurance coverage, including out-of-pocket costs, and payer requirements

Referral to an Independent Foundation

  • Referral to a non-profit organization that may be able to provide financial support

Assess eligibility for PTx Assist Financial Assistance Programs

  • Copay Program: Help with out-of-pocket costs for eligible, commercially insured patients
  • Patient Assistance Program: Assess if your patient is eligible to receive their medication at no cost

Provide Coding And Reimbursement Information

  • Supply relevant coding and reimbursement information for claims submission*

Help with Prior Authorization, Claims and Appeals Support

  • Obtain payer specific requirements prior to treating a patient with BIZENGRI
  • Assist with coverage denials and inadequate reimbursement by working with the payer to understand the appeals process

PTx Assist can Determine Coverage for Your Patients

Step

1

Enroll

  • Complete the Enrollment Form and fax it to 1-855-881-6864

  • After enrolling in PTx Assist, a Case Manager will initiate a Benefits Verification for your patient

Step

2

Benefits Verification

  • Our Case Managers will complete a Benefits Verification

  • Coverage for PTx products will vary by product, plan, and patient.

  • PTx Assist can help determine patient specific coverage requirements.

Step

3

Summary

  • Within 2 business days of receiving the enrollment form, a PTx Assist Case Manager will provide you and your patient with a benefit verification summary

  • PTx Assist can provide eligible patients with information about patient financial assistance programs

PTx Assist can Provide Support Through an Appeals Process

  • Review payer requirements from the benefits verification

  • Discuss the standard process for submitting a prior authorization, appeal, and reimbursement claims

  • Investigate reasons for denied or rejected prior authorizations, appeal, or claims

Review our sample letters

BIZENGRI Sample Letter of Medical Necessity

BIZENGRI Sample Letter of Medical Necessity

This resource provides structure and language to facilitate the initiation and maintenance of a patient who has been prescribed BIZENGRI.

BIZENGRI Sample Appeals Letter

BIZENGRI Sample Appeals Letter

This resource provides an example of the structure and language used when a provider is asking an insurance company to review a decision that denies coverage.

We can also answer coding and reimbursement-related questions*

OR

Call PTx Assist 1-877-353-8546

*HCPs should consult the payer or Medicare contractor to determine the code most appropriate to report for administration. It is the provider’s responsibility to ensure that the codes used are consistent with payer policy and reflect the service performed.