Conducting a Benefits Investigation
Get a full view of your patients’ insurance coverage to help them start treatment quickly.
The staff at REMS-certified healthcare treatment centers can conduct benefits investigations to determine coverage and cost considerations for patient access to SPRAVATO®. The treatment center can also partner with SPRAVATO withMe for support.
Once your patient is enrolled in SPRAVATO withMe, as part of the benefits investigations, we’ll evaluate:
Medical and pharmacy benefit coverage
Behavioral health organizations (BHO) and employee-subsidized plan coverage
Prior authorization requirements, followed by appeals process if needed
REMS-certified pharmacy options that are accepted by the patient’s insurance
Coding and reimbursement information, as well as appeals process
Affordability program eligibility
Information about your patients’ insurance coverage, cost support options, and treatment support is given by service providers for SPRAVATO withMe. The information you get does not require you or your patient to use any Janssen product. Because the information we give you comes from outside sources, SPRAVATO withMe cannot promise the information will be complete. SPRAVATO withMe cost support is not for patients in the Johnson & Johnson Patient Assistance Foundation.
SPRAVATO withMe is limited to education for patients about SPRAVATO®, its administration, and/or their disease, and is not intended to provide medical advice, replace a treatment plan from the patient’s doctor or nurse, or provide case management services.