ClaimSecure Customer Response Centre: 1-888-513-4464 Website: www.claimsecure.com Special Authorization forms are available from the Customer Response Centre (by mail), or may be directly downloaded from the website. In addition, your company’s plan administrator may keep a small supply on hand. Page | 5
How does the claimsecure program work?
Together, ClaimSecure and the manufacturer work together to ensure patients have access to their medicine when they need it, while providing value to sponsors. Leveraging a national specialty drug network of pharmacies and case management services, this program offers both plan sponsors and plan members several benefits.
What is a patient assistance program (PAP)?
Patient assistance programs (PAPs) aim to bring lifesaving therapies to patients who need financial support. McKesson RxO and RxCrossroads by McKesson can support medication access across healthcare settings—and uncover hidden revenue for your organization.
How do I access a Dental Claim Form?
To access a dental claim form, visit the "Forms" library located on the Home Page or simply "click here" Please Note: There is a per claim maximum of %m for drug online claims submissions. Claims exceeding this amount will be pended for adjudicator review.
How do I add a provider to my claim?
To add a provider to your claim, please use the Search for a Provider option. Lab fees are not eligible to be submitted online; Please submit the claim by mail or fax 1-866-613-0530. Lab fees are not eligible to be submitted online.
What is claim secure in BC?
ClaimSecure focuses on managing its clients' healthcare costs by providing automated health benefit plan services, customized plan designs and sophisticated clinical and adjudication controls.
What does special authorization mean?
Special authorization is a mechanism to provide access to certain drugs according to defined clinical criteria. Special authorization request forms are completed by physicians and reviewed by clinical pharmacists. Prior approval must be granted to ensure coverage by special authorization.
What does claim secure mean on a prescription?
ClaimSecure offers a Special Authorization Drug Program to ensure that you receive the most. appropriate and cost effective drug therapy. If your program includes Special Authorization, in order to. obtain a special authorization drug you will be required to complete a Special Authorization form. This.
How does special authority work?
Special Authority (SA) grants coverage to a drug, medical supply or device that otherwise would not be eligible for full coverage. Coverage is provided to patients in specific medical circumstances and depends on the patient's PharmaCare plan rules, including deductible requirements.
What is healthcare authorization?
Authorization in medical billing refers to the process wherein the payer authorizes to cover the prescribed services before the services are rendered. This is also termed as pre-authorization or prior authorization services.
What is the authorization government?
Government Authorizations Government Authorization means any approval, consent, license, permit, waiver, or other authorization issued, granted, given or otherwise made available by or under the authority of any Government Authority or pursuant to any Legal Requirement.
What is drug assistance?
Drug assistance programs—another term for patient assistance programs—can also be offered by state programs or independent third-party nonprofits/charitable organizations. Whether a patient qualifies for these programs will depend on their insurance and the prescribed therapy. Patients typically qualify for these programs if they do not have ...
Who sponsors drug assistance programs?
Drug assistance programs are usually sponsored by life sciences organizations (manufacturer- sponsored), non-profit or charitable foundation-sponsored, or a combination of the two. Usually, they also fall into these categories:
Why are patients more likely to abandon their prescriptions at the pharmacy counter?
As out-of-pocket costs increase, patients are more likely to abandon their prescriptions at the pharmacy counter. To avoid this outcome and improve patient adherence, pharmaceutical manufacturers are more likely to sponsor patient assistance programs.
Can't afford medication?
According to a 2019 Keiser Family Foundation poll, one in four Americans can’t afford their medications, and 29% reported not taking their medications as prescribed due to cost. There are several types of drug assistance programs that can ensure the patients who need treatment gain timely access to therapy and continuity of care.
Can patients receive medication for little or no cost?
Patients who qualify for patient assistance programs can receive medication for little or no cost, helping the most in-need patients gain access to therapy if they cannot afford the typical drug pricing.
Available medicines
Find out if the medicine your doctor prescribed is available through the Bristol Myers Squibb Patient Assistance Foundation.
Eligibility
Complete a brief assessment to see if you might be eligible for assistance.
How to apply
We'll need some information from both you and your doctor to process your application.
How long does it take to get a claim receipt from ClaimSecure?
You are responsible for producing and providing the original receipts to ClaimSecure within 30 days.
What is HSA reimbursement?
HSA allows members and eligible family members to be reimbursed for health and dental expenses that are not covered by their group or provincial health plans. Typical expenses include deductibles or coinsurances and amounts in excess of maximum coverage. Expenses must qualify for a medical expense tax credit with the Canada Revenue Agency (CRA) to be eligible under this program.
How long do you have to keep original claim receipts?
You are responsible for retaining original claim receipt (s) for 12 months following the date of your online claim submission (s).
What is an unrecognized provider?
A medical provider, clinic or practitioner that is not part of ClaimSecure's Provider Network. Claims originating from this "Unrecognized Provider" are not covered services and will not be eligible for reimbursement.
Do you have to submit a claim to your core plan?
If you have Drug, Dental or Extended Health (core plan) benefit coverage, then this document is to remind you that you must first submit your claim for consideration under your core plan. If you have not already done this, please do so now.
Can you owe overpayment to claim secure?
Any monies or overpayment that you may owe to ClaimSecure in accordance with the provisions of the Group Benefit plan will be repaid to ClaimSecure upon demand.
Does ClaimSecure audit claims?
I understand and agree that ClaimSecure will conduct audits of claims submitted by me for purposes including, but not limited to, preventing and detecting fraud. I authorize ClaimSecure, and persons acting for ClaimSecure, to disclose this claim, or any personal information contained in this claim, to the benefit plan sponsor/employer for the purposes of reporting fraud suspicious claims. I am aware that ClaimSecure, or persons acting on its behalf, may be required or permitted by law to disclose this claim, and the information contained in this claim, to others without my knowledge or consent or the consent of the individual to whom the information relates.
How much of the drug ingredient cost is covered by Dexilant?
The DEXILANT Patient Assistance Program will ensure that a maximum of 75% of the drug ingredient cost for your DEXILANT prescription will be covered. Click here to get your card!
What is the RxHelp app?
The RxHelp mobile app is easy-to-use and saves you money on prescriptions. Best of all, you always have the discount card on your phone.
