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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 need 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.
It's free to use and you may already have an account.
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.
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 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
The following codes may be relevant when billing for NUCALA and its administration.
CMS-1500 form
Use for services provided in physician office
CMS-1450 form
Use for services provided in hospital outpatient department
Sample letter of medical necessity
Offers guidance that may be helpful when establishing medical necessity
Sample appeal letter
Offers guidance that may be helpful when filing an appeal for a denied claim
These resources are provided for information purposes only; it is the responsibility of providers to complete these forms based upon their best clinical judgment and in accordance with the payer's process.
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 & coding
- Affordability programs such as copay assistance
The information provided by the ARM is not a guarantee of coverage or reimbursement.