Your dedicated team provides
sources of support
SERVICE CENTER
SERVICE CENTER
Access Specialist
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Provide information regarding insurance verification
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Explain patient affordability solutions
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Advise on prior authorization research and offer appeals support
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Address billing support and coding questions
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Explain patient affordability solutions
Dedicated Access Specialists are available Monday to Friday, 8:00 AM to 8:00 PM (ET).
CALL 1-833-LEQVIO2 (1-833-537-8462)
CALL 1-833-LEQVIO2(1-833-537-8462)
Field Reimbursement Manager
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Provide payer coverage information
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Provide reimbursement support
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Explain specific product acquisition options for LEQVIO
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Answer questions regarding patient support program offerings, including co-pay and adherence support
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Provide information on local payer billing/coding/claim submission policies and procedures
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Provide reimbursement support
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Answer questions regarding patient support program offerings, including co-pay and adherence support
Available for in-office visits or by phone.
Ask your LEQVIO Sales Specialist
for your Field Reimbursement Manager's contact information.
Available for in-office visits or by phone. Ask your LEQVIO Sales Specialist for your Field Reimbursement Manager's contact information.
Self-Service Website
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Comprehensive resources on acquisition, affordability, reimbursement, and all patient support programs
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Alternate Injection Center Locator Tool
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Live Click-to-Chat
LEQVIO-ACCESS.COM
SALES SPECIALIST
SALES SPECIALIST
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Provide clinical product information
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Sales Specialists do not have access to patient-level data
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Review general acquisition information
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Offer information regarding
co-pay and adherence
support options
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Sales Specialists do not have access to patient‑level data
SPECIALIST
LEQVIO aims to be affordable for your patients
Medicare Part B
Nearly 80% of patients with Medicare Part B fee-for-service coverage also have supplemental (ie, Medigap or secondary) insurance and may pay as little as $0 out-of-pocket for LEQVIO.
Commercial
Eligible commercially insured patients may pay as little as $0 for each LEQVIO treatment with the co‑pay card. Subject to terms and conditions. Limitations apply.*
Eligible commercially insured new patients may be able to receive up to two (2) free doses if coverage is delayed or denied. Subject to terms and conditions. Limitations apply.†
For commercially insured patients
*Limitations apply. Valid only for those with commercial insurance. For patients covered under the medical benefit, rebate for out-of-pocket costs will be assigned directly to provider, unless patient requests direct reimbursement. Patient is responsible for any costs once limit is reached in a calendar year. Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, (iii) where the patient's insurance plan reimburses for the entire cost of the drug, or (iv) where product is not covered by patient's insurance. The value of this program is exclusively for the benefit of patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, and deductibles. Program is not valid where prohibited by law. Patient may not seek reimbursement for the value received from this program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. Valid only in the United States and Puerto Rico. This Program is not health insurance. Program may not be combined with any third-party rebate, coupon, or offer. Proof of purchase may be required. Novartis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.
†Terms & Conditions
Bridge to Commercial Program Terms & Conditions: Eligible patients must have commercial insurance, a valid prescription for LEQVIO, and a prior authorization, predetermination, or medical exception that has been denied or pending for greater than 3 calendar days. Program provides up to two (2) doses of free medication. Program is not available to patients who are uninsured or whose medications are reimbursed in whole or in part by Medicare, Medicaid, TRICARE, or any other federal or state program, or where prohibited by law. No purchase necessary. Program is not health insurance, nor is participation a guarantee of insurance coverage. Other limitations may apply. Novartis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.
You can enroll your patients in 3 different ways:
Download and fax our 1-page
start form to 1-877-LEQVIO8
(1-877-537-8468)
Patient Start Form
Enroll your patients electronically
via ServiceCenterPortal.com
for
all services, including co-pay
CENTER PORTAL
Enroll your patients electronically
via LEQVIO-CoPayPortal.com
for
co-pay–only support
LEQVIO-COPAY PORTAL.COM
LOOKING FOR MORE
INFORMATION
FOR
YOUR PATIENTS?
LEQVIO supports your practice through flexible acquisition
IN-OFFICE ADMINISTRATION
Acquire LEQVIO through buy-and-bill
or an SP
BUY-AND-BILL
Administration takes place in
your office (Medical Benefit)
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Buy-and-bill is an option for acquiring drugs covered under the medical benefit that are administered by a health care provider
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Drugs covered under Medicare Part B (fee-for-service) must be acquired through this method
THE BUY-AND-BILL
PROCESS
Verify benefits
Order LEQVIO through a distributor
HCP/office staff orders LEQVIO, assuming responsibility for storing and handling. A list of authorized LEQVIO distributors can be found here. If your practice is part of a system that uses a central purchasing model, then the buy-and-bill process steps may not apply
Administer LEQVIO
HCP administers LEQVIO in their office
Submit claim
HCP/office staff submits claim to payer for reimbursements
Manage reimbursement
HCP/office staff receives reimbursement from payer and collects balance due (if any) from patient
ABOUT BUY-AND-BILL
SPECIALTY PHARMACY
Administration takes place within your office via an SP
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A patient's plan may restrict drug coverage under the pharmacy benefit using an SP
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LEQVIO ordered through an SP must be given to the specific patient for whom it was ordered (unlike the buy-and-bill, in which LEQVIO can be given to any patient for whom it's prescribed)
THE SP
PROCESS
Patient's plan restricts coverage to the pharmacy benefit, or HCP prefers this pathway and the patient is eligible for the pharmacy benefit
Send Rx
HCP sends prescription via e-prescribing platform to SP
Benefits verification (BV)
SP conducts BV, receives Statement of Benefits, and coordinates prior authorization or precertification as needed
Patient payment
Patient pays co-pay/coinsurance or deductible when SP dispenses LEQVIO
Send drug
SP sends LEQVIO to HCP practice or as dictated by insurance coverage
Store and schedule
HCP practice schedules patient injection visit and stores LEQVIO if needed
Administer
HCP practice administers LEQVIO to the patient
Collect for services
HCP practice collects patient co-pay for any services (administration fee)
SERVICE CENTER
OUT-OF-OFFICE
ADMINISTRATION
Send order to an AIC, which manages
LEQVIO acquisition via buy-and-bill
ALTERNATE INJECTION CENTER (AIC)
Administration takes place at a site other than your office
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Practice locates and refers the patient to an AIC, which then handles the following:
- Benefits verification
- Prior authorization support
- Acquisition of LEQVIO
- Administration of LEQVIO
- Submitting claims for reimbursement -
A system hospital outpatient department (HOPD) may act as an AIC. It's important to understand system requirements before sending the LEQVIO patient to that facility
THE HCP/OFFICE STAFF
ROLE IN THE AIC PROCESS
Locate
HCP/office staff finds an AIC that is convenient for the patient
Refer
HCP/office staff contacts AIC to determine referral requirements, then completes and submits the referral form, including the LEQVIO order with all the required information to the AIC
Follow-up
HCP may receive a report on the patient's LEQVIO administration from the AIC and determines whether follow-up between appointments may be necessary for the patient
*May include a clinic, hospital outpatient department, or another physician's office.