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Kineret® Reimbursement Services
To assist you with reimbursement and insurance coverage, Amgen has established a program called the Kineret® Reimbursement Services. Reimbursement
requirements related to Kineret® will vary by payor. To assist you in understanding individual payor policies and patient-specific coverage guidelines, Amgen has
implemented a dedicated reimbursement support service. When you call the Kineret® Customer Call Center at
1-866-KINERET (1-866-546-3738), reimbursement counselors are available Monday through Friday, 8 AM to 8 PM EST, to help with the following:
- Insurance verifications. A reimbursement counselor can contact your patient's insurance company directly to confirm plan-specific benefits and restrictions. Specifically, the reimbursement counselor can investigate coverage requirements (such as prior authorization), patient's responsibilities for the cost of Kineret®, and guidelines for obtaining Kineret® (such as through a retail pharmacy network or through mail order).
- Prior authorization support. When prior authorization is required, reimbursement counselors can assist with researching the requirements of the prior authorization process, drafting patient-specific letters of medical necessity, and tracking status of prior authorization determinations. When payors require a "recertification," reimbursement counselors will contact you to remind you of the coverage requirement and provide you with support as needed (such as an updated sample letter).
- Coding assistance. Reimbursement counselors can provide coding assistance for Kineret®.
- Billing assistance. Reimbursement counselors can research payor-specific claim submission guidelines and can review completed claim forms for accuracy.
- Assistance with the appeal's process. Reimbursement counselors can assist with appealing claims that have been denied or underpaid. This includes contacting payors directly to research the appeal process, providing template letters, recommending supporting documentation to include in the appeal package, and tracking the status of the appeal review.
Before calling the Kineret® Customer Call Center regarding a patient-specific reimbursement issue,
please have the following information ready to give the reimbursement counselor:
- Patient's demographic information (including name, address, phone number, date of birth, and social security number)
- Basic medical history
- Payor name, policy number, payor phone number
- Insured's name, date of birth, and social security number (if other than patient)
- Explanation of benefits (EOB) letter (if calling regarding a denied claim)
- Patient authorization to share patient-specific information
- Provider number or tax identification number
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Additional Resources
To further assist you and your patients, Amgen has established the Kineret® Customer Call Center.
By contacting one number, you can be connected with a comprehensive range of services and information, including:
- Reimbursement Support. Reimbursement counselors are available from 8 AM to 8 PM (EST)
to help health care providers and patients understand the patient's coverage situation regarding Kineret®.
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