The Organon Access Program may be able to help answer questions about access and support, including:
- Benefit investigations and information about prior authorizations and appeals
- Co-pay assistance for eligible patients
- Referral to the Organon Patient Assistance Program for eligibility determination
- Billing and coding
Click on the Medication Below for Information or to Enroll:
BILDYOS®
BILPREVDA®
HADLIMA®
NEXPLANON®
ONTRUZANT®
RENFLEXIS®
TOFIDENCE®
Overview of The Organon Access Program
The Organon Access Program can contact insurers to request coverage and benefits information.
The Organon Access Program provides billing and coding information that may be relevant for your patient’s medication and its administration. Office staff may call The Organon Access Program with specific questions about codes that may be relevant when billing for the medication and its administration.
If a prior authorization is required, or for assistance in understanding if a prior authorization is required, The Organon Access Program may be able to help.
The prior authorization checklist and sample letter can help you to understand the documents and information that may be helpful when seeking a prior authorization. As always, you should check for payer-specific requirements.
If you have submitted a claim and the claim has been denied, you can submit an appeal to your patient’s insurer.
The Organon Access Program may be able to help your office understand the information needed for an appeal submission.
The appeal checklist and sample appeal letter can help you to understand the documents and information that may be helpful when filing an appeal. As always, you should check for payer-specific requirements.
The Organon Co-pay Assistance Program offers assistance to eligible privately insured patients who need help affording the out-of-pocket costs for their medication.
Co-pay assistance from the Organon Co-pay Assistance Program is not insurance. Restrictions apply. See the Terms and Conditions for the applicable product program.
Patient and health care professional must submit all required information. Please see the enrollment form for the applicable product for details.
Your patients may also be able to get help from an independent assistance foundation. Independent assistance foundations may be able to help patients who are encountering hardships affording their prescribed medications or who do not qualify for other forms of financial support. Each foundation determines its own eligibility criteria and application process and is independent from Organon; there is no guarantee a patient will receive any type of assistance from these organizations.
The Organon Access Program representatives can refer patients to the Organon Patient Assistance Program for eligibility determination (provided through the Organon Patient Assistance Program Inc.).
Getting Started Is Simple
Click on the Enroll Now button to complete the enrollment. If preferred, you may download the form and fax it in.
A program representative will contact your office and your patient.
The information available here is compiled from sources believed to be accurate, but Organon makes no representation that it is accurate. This information is subject to change. Payer coding requirements may vary or change over time, so it is important to regularly check with each payer as to payer-specific requirements.
The information available here is not intended to be definitive or exhaustive, and is not intended to replace the guidance of a qualified professional advisor. Organon and its agents make no warranties or guarantees, express or implied, concerning the accuracy or appropriateness of this information for your particular use given the frequent changes in public and private payer billing. The use of this information does not guarantee payment or that any payment received will cover your costs.
You are solely responsible for determining the appropriate codes and for any action you take in billing. Information about HCPCS codes is based on guidance issued by the Centers for Medicare & Medicaid Services applicable to Medicare Part B and may not apply to other public or private payers. Consult the relevant manual and/or other guidelines for a description of each code to determine the appropriateness of a particular code and for information on additional codes. Diagnosis codes should be selected only by a health care professional.
HCPCS, Healthcare Common Procedure Coding System.