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| Tips for filling out the Patient Enrollment Form |
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- Enter information directly into enrollment form. The Patient Enrollment Form allows you to enter information directly into it. Entering the information directly into the form then printing is preferred since the form’s content will be more legible.
- Use the correct codes. Make sure the diagnosis codes used for billing match the healthcare provider's notes and pathology, and that the primary and secondary codes have not been reversed in error. For additional information on Coding Information Click Here.
- Use the correct Provider and Patient ID numbers. Make sure the Provider and Patient ID numbers are entered correctly by confirming with the Provider and Patient.
- Submit all required supporting documents with the claim. Provide the healthcare provider name, provider ID#, patient name, payor policy number, date of service, and any other appropriate identifying information on each document.
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| Suggestions for managing the reimbursement process |
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- Follow Proper Billing Procedures. Use the correct billing unit and bill for the amount of TRISENOX® or TREANDA® administered. Review the patient's payor guidelines and follow proper billing procedures. Include all required information.
- Understand payor guidelines. Obtain prior authorization requirements and PCP referrals when necessary. Determine if the payor will cover treatment provided only in a particular setting. Keep up to date on payor policy changes and effective dates. Payor websites and newsletters are often good sources for this information.
- Submit claims and documents by the required deadlines.
- Keep a copy of all forms and documents that are submitted.
- Follow up. If payment is not received within 30 to 45 days after submitting the claim, follow up with the payor.
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