Benefit Verification Process on Astellas eService

1. Healthcare provider submits a Benefit Verification Request via Astellas eService.

ARS no longer requires the healthcare provider to submit a completed HIPAA form with the Benefit Verification Request. ARS requires the healthcare provider to retain proof of patient signature on file in their office.
2.

An ARS reimbursement specialist contacts the payer(s) within one business day to verify patient-specific coverage, including:

  • Patient eligibility for benefits
  • Requirements for prior authorization, step therapy, or other coverage restrictions
  • Patient cost to fill prescription (co-payment, coinsurance, benefit cap)
  • Any coding or claim-submission requirements of payer
3. After the benefit verification is complete, an ARS reimbursement specialist provides the healthcare provider a comprehensive Summary of Benefits in his or her user profile on Astellas eService.
4. ARS reimbursement specialists are available to review the Summary of Benefits and answer any healthcare provider questions.

 

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