Strong Formulary Access
PROVENGE reimbursement is comprehensive:
- Medicare—All Medicare Administrative Contractors cover PROVENGE for use within the FDA-approved label, per the National Coverage Determination
- Commercial—Plans representing 99% of patients with private insurance cover PROVENGE, based on the FDA-approved label
The average time from bill to payment is approximately 30 days (Medicare and commercial payers)
In addition to the programs below, you can find a number of PROVENGE reimbursement resources here to help you navigate the insurance process, from patient enrollment through the appeal process for denied claims.
For more information, visit PROVENGEreimbursement.com.
Comprehensive PROVENGE Insurance Reimbursement Resources
Dendreon ON Call
Dendreon ON Call is designed to be a comprehensive and convenient resource for health care professionals seeking to use PROVENGE for their patients. When a patient begins therapy with PROVENGE, dedicated Dendreon ON Call reimbursement coordinators will provide support with the reimbursement process, and local field reimbursement business managers will be available to answer questions upon request.
Examples of assistance that a reimbursement coordinator can provide include:
- Patient enrollment, to ensure accuracy and minimize delays
- Benefits verification
- Prior authorization criteria support
- Claims appeal support
Although PROVENGE has robust coverage with major commercial and public payers, Dendreon is committed to helping your patients who are eligible for treatment gain access to patient assistance.
Patient Assistance Programs can help your patients in many ways. Dendreon has continued to enhance the Patient Assistance Programs available by introducing PROvide, a program specifically designed for patients who are covered by commercial insurance.
Download an enrollment form for your patients to apply for Patient Assistance Programs.
Learn more about patient assistance from Dendreon.