![]() The patient further understands and authorizes Accord BioPharma to use any consumer reports about them and information collected from them, along with other information they obtain from public and other sources, to estimate their income in conjunction with the AccordCares Patient Assistance Program eligibility determination process. ![]() The patient understands that, upon request, Accord BioPharma will tell them whether an individual consumer report was requested and the name and address of the agency that furnished it. The patient authorizes Accord BioPharma to use their demographic information to access reports on their individual credit history from consumer reporting agencies for the purposes of determining their income eligibility. The patient also agrees that Accord BioPharma may verify their eligibility for the AccordCares Program, and the patient understands that such verification may include contacting them or their healthcare provider for additional information and/or reviewing additional financial, insurance, and medical information. In addition, the patient agrees to notify AccordCares promptly if their insurance situation changes. Continuation in the program is conditioned upon timely verification of income. If requested, the patient agrees to provide proof of income within 30 days of the request. The patient must deduct the value of this assistance from any reimbursement request submitted to their private insurance plan, either directly by the patient or on their behalf.ĪccordCares may ask for proof of income at any time for the purpose of audit/verification. This offer is not valid when the entire cost of their prescription drug is eligible to be reimbursed by their private insurance plans or other private health or pharmacy benefit programs. To be eligible, the patient must have private insurance with coverage of CAMCEVI. ![]() The program does not cover or provide support for supplies, procedures, or any physician-related service associated with CAMCEVI. Program offer is not valid for cash-paying patients and the patients are responsible for any out-of-pocket costs for CAMCEVI that exceed the annual maximum. This program is not valid for patients who are enrolled in a state or federally funded insurance program, including but not limited to Medicare, Medicaid, TRICARE, Veterans Affairs health care, a state prescription drug assistance program, or the Government Health Insurance Plan available in Puerto Rico (formerly known as “La Reforma de Salud”). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |