For my DMT's manufacturer copay program — the Ocrevus Co-pay Program, Alongside Kesimpta, Biogen Above MS Support, or Briumvi Patient Support — is your office enrolling me, or do I need to sign up myself?
For preauthorization — is your office submitting it, what do you need from me, and when will I know if it's approved?
If my insurance uses a third-party copay accumulator — SaveOnSP, PrudentRx, Payer Matrix, SHARx, or Paydhealth — is your office handling enrollment, or do I need to opt in myself? And how does that affect my manufacturer copay?
If my DMT is infused, where will the infusions happen — hospital outpatient, a standalone infusion center, or at home? Costs can vary by thousands. Do I have a choice, and which site is cheapest for me?
Which specialty pharmacy will my DMT come through, and is there one you prefer for MS patients?
How often do I need to see you for insurance to keep covering my treatments? And what's the lead time for approvals so we can plan ahead?
If something gets denied, can we appeal — and can we request a peer-to-peer review?
Can you write a letter of medical necessity if my insurance pushes back?
Do you have a financial counselor or case manager I can talk to?
If my insurance changes mid-year, what happens to my treatment? How do we avoid a gap?