Providing Timely Solutions

When you contact the Reimbursement Connection®, you can access a variety of reimbursement services for Amgen products.

Specialized service
Speak to a reimbursement expert who specializes in the insurance policies of your region.

Payor policy research and information
Have our reimbursement experts research payor coverage, coding, and reimbursement policies.

Insurance verification assistance
Let us assist you in verifying your patients' benefits and identifying insurer coverage guidelines.

Prior authorization assistance
Allow us to research your patients' prior authorization requirements, help you obtain prior authorization, and remind you when the next prior authorizations are needed.

Claim review and reconciliation
Help you track the progress of your claims and, when needed, work with the insurer to identify the reason(s) for denied or underpaid claims and necessary actions to resolve the problem.

Coordination of benefits
Coordinate primary and secondary coverage for collection of co-payments or co-insurance.

Alternative sources of payment
Ask us to help identify alternative coverage sources for Amgen products -- Non-Profit Co-Payment Assistance Programs

Support Programs
Let us provide information on the SAFETY NET® Foundation for medically indigent patients.

The Reimbursement Connection® provides solutions and reduces the time you spend on reimbursement issues. With patient consent, our staff can provide help in:



Identifying steps for smooth claim processing

Provider Reimbursement Connection® Staff
Provider calls
1-800-272-9376
to determine if a patient is covered for an Amgen product.
  • With appropriate patient authorization takes patient, provider, and insurer information
  • Reviews insurer's written policies
  • Contacts insurer to verify patient's benefits
  • Identifies billing and prior authorization requirements (if applicable)
Provider submits claim and contacts the Reimbursement Connection® if additional assistance is required.
  • Informs caller of research findings and insurer requirements
  • Provides billing materials
  • Offers to track claim progress and assist with prior authorization


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Assisting with resolution of claim delays and denials

Provider Reimbursement Connection® Staff
Provider calls
1-800-272-9376
for assistance with a problem claim.
  • With appropriate patient authorization reviews the claim and EOB for submission errors
  • Reviews insurer policy for insight into problem
  • Contacts the insurer to determine reason(s) for denial or delay
  • Discusses with insurer necessary steps to reconcile claim
Provider submits claim and contacts the Reimbursement Connection® if additional assistance is required.
  • Informs caller of research findings and steps to reconcile claim
  • Provides materials
  • Offers to track claim and follow up with provider


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Verifying insurance coverage and researching funding alternatives

Provider Reimbursement Connection® Staff
Provider calls
1-800-272-9376
to determine if a patient is covered for an Amgen product.
  • With appropriate patient authorization takes patient, provider, and insurer information
  • Contacts insurer to verify patient's benefits
  • Contacts the caller with the insurance status
When insurance coverage is inadequate or not available, the Reimbursement Connection® staff:
  • Case-manages the patient, as each patient's situation is unique
  • Researches an alternate funding database for additional sources of financial assistance through public and private sources
  • Provides contact information for agencies that may be able to assist patient
  • Screens the patient for the SAFETY NET® Foundation
  • Referral to non-profit co-payment assistance programs

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Enrolling patients with medical needs with one call

The SAFETY NET® Foundation provides replacement of Amgen products for medically needy patients who meet its eligibility criteria.

Provider SAFETY NET® Foundation Staff
Provider calls
1-800-272-9376
With appropriate patient authorization SAFETY NET® Foundation staff takes patient information and screens patient for program eligibility over the phone
Provider reviews prefilled enrollment form for accuracy, signs, and returns it to the SAFETY NET® Foundation
SAFETY NET® Foundation staff sends prefilled enrollment form to sponsor for physician's signature, if patient is eligible
Patient Receives Treatment
Sponsor submits product replacement request
SAFETY NET® Foundation staff ship replacement product directly to provider for free product provided to patient
Eligible patients may be enrolled for up to 1 year and may reapply.


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The information provided in this section is of a general nature and for informational purposes only. Coding and coverage policies change periodically and often without warning. The responsibility to determine coverage and reimbursement parameters and appropriate coding for a particular patient and/or procedure is always the responsibility of the provider or physician. The information provided in this section should in no way be considered a guarantee of coverage or reimbursement for any product or service.

Aranesp® (darbepoetin alfa) Indications and Important Safety Information including Boxed WARNINGS

Indications

Aranesp® is indicated for the treatment of anemia:

  • associated with chronic renal failure (CRF), including patients on dialysis and patients not on dialysis.
  • in patients with non-myeloid malignancies where anemia is due to the effect of concomitantly administered chemotherapy. Aranesp® use has not been demonstrated in controlled clinical trials to improve symptoms of anemia, quality of life, fatigue, or patient well-being. Aranesp® is not indicated for use in patients receiving hormonal agents, therapeutic biologic products, or radiotherapy unless receiving concomitant myelosuppressive chemotherapy.

Important Safety Information including Boxed WARNINGS

WARNINGS: INCREASED MORTALITY, SERIOUS CARDIOVASCULAR and THROMBOEMBOLIC EVENTS, and TUMOR PROGRESSION

Renal failure: Patients experienced greater risks for death and serious cardiovascular events when administered erythropoiesis-stimulating agents (ESAs) to target higher versus lower hemoglobin levels (13.5 vs. 11.3 g/dL; 14 vs. 10 g/dL) in two clinical studies. Individualize dosing to achieve and maintain hemoglobin levels within the range of 10 to 12 g/dL.

Cancer:

  • ESAs shortened overall survival and/or time-to-tumor progression in clinical studies in patients with breast, non-small cell lung, head and neck, lymphoid, and cervical cancers when dosed to target a hemoglobin of > 12 g/dL.
  • The risks of shortened survival and tumor progression have not been excluded when ESAs are dosed to target a hemoglobin of < 12 g/dL.
  • To minimize these risks, as well as the risk of serious cardio- and thrombovascular events, use the lowest dose needed to avoid red blood cell transfusions.
  • Use only for treatment of anemia due to concomitant myelosuppressive chemotherapy.
  • Discontinue following the completion of a chemotherapy course.

Aranesp® is contraindicated in patients with uncontrolled hypertension. Patients with chronic renal failure (CRF) experienced greater risks for death and serious cardiovascular events when administered erythropoiesis-stimulating agents (ESAs) to target higher versus lower hemoglobin levels in two clinical studies. Patients with CRF and an insufficient hemoglobin response to ESA therapy may be at even greater risk for cardiovascular events and mortality than other patients. Aranesp® and other ESAs increased the risks for death and serious cardiovascular events in controlled clinical trials of patients with cancer. These events included myocardial infarction, stroke, congestive heart failure, and hemodialysis vascular access thrombosis. A rate of hemoglobin rise of > 1 g/dL over 2 weeks may contribute to these risks. Seizures have occurred in patients with CRF participating in Aranesp® clinical trials.

Cases of pure red cell aplasia (PRCA) and of severe anemia, with or without other cytopenias, associated with neutralizing antibodies to erythropoietin have been reported in patients treated with Aranesp®. This has been reported predominantly in patients with CRF receiving Aranesp® by subcutaneous administration. A sudden loss of response to Aranesp®, accompanied by severe anemia and low reticulocyte count, should be evaluated. If anti-erythropoietin antibody-associated anemia is suspected, withhold Aranesp® and other erythropoietic proteins. Aranesp® should be permanently discontinued in patients with antibody-mediated anemia. Patients should not be switched to other erythropoietic proteins as antibodies may cross-react.

The most commonly reported side effects in clinical trials in patients with CRF were infection, hypertension, hypotension, myalgia, headache, and diarrhea. The most commonly reported side effects in clinical trials in patients with anemia due to concomitant chemotherapy were fatigue, edema, nausea, vomiting, diarrhea, fever and dyspnea.

Please click here for accompanying Aranesp® package insert for full prescribing information, including Boxed WARNINGS.

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