Benefit Verification Overview

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Reimbursement Services
Benefit Verification
Benefit Verification Process

Sample Summary of Benefits

Benefit Verification Q & A
Prior Authorization
Prior Authorization Assistance Process

Sample Summary
of Benefits
Billing and Claims Assistance
Coding and Claims Processing

Overview of Required Documentation for AmBisome

Relevant Codes for AmBisome

Quarterly Coding and Billing Reference Sheets

CMS-1500 Completion Guide

Sample CMS-1500 Claim Form

CMS-1450 Completion Guide

Sample CMS-1450 Claim Form

Claims and Billing Assistance Process

Appealing Claims

Billing and Claims
Q & A

Benefit Verification

To help you understand how AmBisome may be covered by your patient’s insurance plan, Astellas Reimbursement Services^SM (ARS) can research the patient’s coverage before treatment is started to minimize any potential disruption in their course of therapy.

ARS benefit verifications support improved patient care in the following ways:

Research your patient’s coverage profile including prior authorization requirements or other coverage restrictions
Investigate your patient’s cost-sharing responsibilities including the deductible, co-insurance/co-payment, out-of-pocket maximum, and benefit cap
Outline next steps for accessing AmBisome including coding, claim submission requirements, and pharmacy options
Counsel healthcare providers by offering assistance with the appeals or grievance process
Evaluate eligibility for, and refer the patient to, the Astellas Access Program^SM (AAP) to help ensure that the patient will be able to start or continue their therapy

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