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How To Enroll

Accessing the KabiCare Patient Support Program or ONLY the KabiCare Copay program for STIMUFEND® (pegfilgrastim-fpgk)

We understand how complicated, costly, and overwhelming cancer treatment can be for your patients. The KabiCare Program provides a potential solution for eligible patients to receive financial support for STIMUFEND®.

Enrollment into KabiCare patient support program

If eligible, a patient will be enrolled into copay as part of full enrollment into the KabiCare Patient Support Program.

 

Enrollment into KabiCare Copay Support Only

Enrollment into KabiCare Copay Support IconPatients with commercial insurance may be eligible* for the copay program, which may lower their out-of-pocket costs to as little as $0/month for treatment with an annual maximum.

*Eligibility criteria apply. Patients are not eligible for commercial copay assistance if the prescription is eligible to be reimbursed, in whole or in part, by any state or federal healthcare program.

Claim submission and reimbursement

STIMUFEND will most commonly be covered under the patient’s pharmacy benefit.

1 Pharmacy Benefit Adjudication

  • The pharmacy will submit a secondary claim to PDMI by TrialCard using the information below:
    • Copay Program Member ID
    • Group Number: 50777975
    • RxBin: 610524
    • RxPCN: Loyalty
  • The pharmacy will receive real-time notification of the paid benefit amount.
  • The pharmacy will collect the remaining patient responsibility, if any.

In the event STIMUFEND is covered under the patient’s medical benefit plan, please review the following for claims submission and reimbursement guidelines:

2 Medical Benefit Copay Claims

  • Claims can be faxed to 833-966-3050
  • Claims can also be mailed to the following address:
    KabiCare Copay Program Program
    2250 Perimeter Park Dr., Suite 300
    Morrisville, NC 27560You will need to include:
    • Completed Claim form (UB-40 or CMS-1500 Claim form)
    • Primary Explanation of Benefits (EOB) showing itemized Claim form with National Drug
    • Codes (NDCs) listed from the patient’s private insurance company with the cost for the drug listed separately.
  • Your office will receive reimbursement of the patient’s applicable copay or coinsurance. Please allow 7-10 days for receipt of payment.

3 Reimbursement

Healthcare Provider Reimbursement
Providers will be reimbursed either through a paper check or EFT (electronic funds transfer).  If the provider is not enrolled to receive EFT, the provider will receive a notification that includes directions for how to enroll.

Direct-to-Patient Reimbursement
If treatment has already been provided and copay benefits for prescribed Fresenius Kabi products were not explored prior to administration, your patient may still potentially qualify for copay reimbursement.
  • Ensure the patient is enrolled in the copay program.
  • Request an itemized receipt w/ NDC details and drug name
  • Mail or fax these documents to the following:
    KabiCare Copay Program
    2250 Perimeter Park Dr., Suite 300
    Morrisville, NC 27560
    Fax number: 833-966-3050
  • Patient will receive a paper check in 7-14 business days.
  • There is a 180-day lookback period for submitted claims from when the patient was enrolled.

Click here to view the KabiCare Copay Assistance Program TERMS & CONDITIONS