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INSUPPORT BI and Commercial Plans

Across
HCPs use this to be reimbursed for the medical services and supplies used during the administration of the drug.
Self-funded employers groups take responsibility for funding their plans and may make many decisions about care meaning that prior authorization and appeal outcomes may be made by the employer group.
Food and Drug Administration
The directing of a patient to a medical specialist by a primary care physician.
The date that the policy became in force.
Preferred Provider Organization
Covers medications that are prescribed by a healthcare professional and are then self-administered by the patient
This determines the extent to which SUBLOCADE is covered by a Patient’s health insurance plan.
Patients with pre-existing condition clauses in the policy may not be covered for cost incurred if the pre-existing condition recurs.
This is insurance that is provided through governmental means; such as Medicaid, Medicare, or Tricare.
Down
This code is used when no existing HCPCS code adequately describes the item or service being billed
Healthcare Maintenance Organization)
Point of Service
HCPs use this to be reimbursed for the medication that they have purchased
Covers conditions, services, and/or medications that are administered by a healthcare professional in a healthcare setting
Is a requirement that your physician obtain approval from your health insurance plan to prescribe a specific medication for you.
Physicians join managed care networks for the payer’s HMO, PPO, and EPO plans. Patient costs are less when seeing in-network providers
a drug that is in line with SUBLOCADE
This is the type of insurance that employers offer, or that Patients can elect and purchase privately.
This agent will call Payer to obtain benefits information