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Coverage details clarified
Making sure your patients get the medication they need is the top priority, for you and for us. Our support is created with your patient’s needs in mind. Tools are available to help you do the following:
- Navigate acquisition paths (e.g., medical benefit or pharmacy benefit)
- Confirm eligibility for financial support
- Guide through prior authorization requirements
- Information about process for claims submission and appeals
Options for direct access support
GSK is a sponsor of the services provided by eBlu and CoverMyMeds. CoverMyMeds and eBlu are independent third parties. GSK is not responsible for the products and services provided.
Initiate a quick benefits verification
eBlu Solutions is a single portal by which you can quickly verify your patient’s medical and pharmacy benefits and submit prior authorizations. Initiate a benefits verification in less than 60 seconds.
Use of the eBlu platform is not a guarantee of success in obtaining third-party coverage or reimbursement. It is the responsibility of the healthcare provider to submit accurate and complete information. Contact health plans for specific information on their coding, coverage and payment policies. Prior Authorization outcomes are not guaranteed.
Registration through eBlu is required.
Important Notice: Information regarding eBlu is brought to you as a courtesy of GSK.
All trademarks, trade names, or logos mentioned or used are the property of their respective owners. eBlu and GSK are not affiliated entities.
Prior authorization
After deciding to pursue treatment with NUCALA, you can locate and complete the appropriate prior authorization form online through CoverMyMeds.
CoverMyMeds is a no-cost solution that automates the process providers and pharmacists use for prior authorization requests to help patients access their medication faster.*
Use of CoverMyMeds is not a guarantee of success in obtaining third-party coverage or reimbursement. It is the responsibility of the healthcare provider to submit accurate and complete information. Contact health plans for specific information on their coding, coverage, and payment policies. Prior Authorization outcomes are not guaranteed.
Registration through CoverMyMeds is required.
*Compared to phone and fax.
Important Notice: Information regarding CoverMyMeds is brought to you as a courtesy of GSK.
All trademarks, trade names, or logos mentioned or used are the property of their respective owners. CoverMyMeds and GSK are not affiliated entities.
Obtaining NUCALA
Depending on the patient’s insurance, they may obtain NUCALA in different ways:
Patients can receive NUCALA directly from an in-network specialty pharmacy. Remind your patients that the specialty pharmacy will contact them to schedule delivery. If your patient is enrolled in the NUCALA Copay Program, please ensure they have their copay member information handy.
If permitted by the patient's medical benefit, you may be able to order and receive NUCALA from a specialty distributor. After treatment, submit claim to the patient’s insurance, collect copay from the patient if applicable, and for eligible patients, submit appropriate claim information to the NUCALA Copay Program.
With assignment of benefits, you can triage a prescription to a specialty pharmacy. Once approved by the patient's insurance, the specialty pharmacy can ship NUCALA directly to your office for administration. The specialty pharmacy will contact the patient to collect any copay, if the patient is enrolled in the NUCALA Copay Program, the specialty pharmacy will collect copay member information.
See below for more information about each option.
Specialty pharmacy
Buy and bill
Assignment of benefit
NUCALA billing and coding information
J2182
Injection, mepolizumab, 1 mg
Additional information needed may vary by payer and may include the drug name and generic name, total dosage administered, method of administration, and the NDC. Providers should confirm this information by payer.
Code set |
Code |
Description |
|---|---|---|
NDC (National Drug Codes) |
0173-0881-01 00173-0881-01
|
100 mg/mL mepolizumab in 1-mL single-dose vial, which contains lyophilized powder for subcutaneous injection
|
|
|
|
The coding, coverage, reimbursement, and related information presented in this guide is from various third-party sources and is subject to change without notice. GSK cannot guarantee the accuracy or timeliness of these data.
The billing and coding information provided is for your reference only. Reimbursement codes are subject to frequent changes. The accurate completion of claims documentation is the responsibility of the healthcare provider. GSK does not guarantee reimbursement for any services or products.
FOR IN-PERSON REIMBURSEMENT SUPPORT
Connect with an available Access & Reimbursement Manager (ARM)
They can provide general information on your patient’s:
- Coverage
- Prior authorization
- Billing and coding
- Affordability programs such as copay assistance
The information provided by the ARM is not a guarantee of coverage or reimbursement.