OCREVUS and OCREVUS ZUNOVO Coverage

Benefits Investigations Prior Authorization Benefits Reverification OCREVUS ZUNOVO Starter Program

Benefits Investigations

OCREVUS Access Solutions can conduct a benefits investigation (BI) to help you determine if a Genentech medicine is covered, if prior authorizations (PAs) are required, which specialty pharmacy (SP) the health insurance plan prefers and if financial assistance might be needed.

Potential outcomes of a BI:

Treatment is covered
PA is required
Treatment is denied

Once the BI is complete, your Patient Navigator will walk your patient through his or her insurance coverage for OCREVUS or OCREVUS ZUNOVO.

A BI may be initiated once the OCREVUS Start Form is submitted to OCREVUS Access Solutions.

This form can be downloaded from Forms and Documents, submitted online via My Patient Solutions.

The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and health care provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.

Prior Authorization

Your OCREVUS Patient Navigator can help you identify if a prior authorization (PA) is necessary and offer resources as you request it for your patient. Once your practice has submitted a PA, your Patient Navigator can follow up with the payer regarding the PA status. Remember, submitting the PA is the responsibility of the practice. PA support may be provided once the OCREVUS Start Form is submitted to OCREVUS Access Solutions.

If your patient’s request for a PA is not granted, your Clinical and Reimbursement Manager (CRM) or Patient Navigator can work with you to determine your next steps. You can find more tips like this in Forms and Documents.

Benefits Reverification

Your OCREVUS Patient Navigator can help you prepare for subsequent OCREVUS or OCREVUS ZUNOVO treatments by automatically reverifying your patient’s benefits prior to the next scheduled treatment.

OCREVUS ZUNOVO Starter Program

While awaiting a health insurance coverage determination, eligible patients may receive free medicine through the OCREVUS ZUNOVO Starter Program. The OCREVUS ZUNOVO Starter Program is available for eligible insured people who have been prescribed OCREVUS ZUNOVO and are experiencing a delay in insurance approval of >5 business days.

If you believe your patient qualifies for the OCREVUS ZUNOVO Starter Program, submit the completed OCREVUS Start Form, including the completed Patient Consent Form on page 4 and Starter section on page 6, to Genentech Access Solutions. For more information, please contact your OCREVUS representative.

Subject to eligibility requirements and terms and conditions. This program is void where prohibited by law and may not be used in or by residents of restricted states, if applicable.

For assistance, call (877) GENENTECH/(877) 436-3683
6 a.m.–5 p.m. PT, Monday through Friday