Celgene Patient Support Specialist
Meet Samuel

Samuel is a Celgene Patient Support® Specialist. To meet your Specialist, click here.

PhoneFor more information, call 1-800-931-8691

Insurance-related assistance

At the request of the patient, our Specialists are available to assist with each of the following steps in the insurance approval process for prescribed Celgene medications*:

  • Initiate a benefits investigation to determine co-payment and other out-of-pocket costs
  • Assess prior authorization or precertification requirements
  • Educate patients about insurance coverage or other programs for which they may qualify

If you need assistance with the prior authorization or precertification process, or are following up on a prior authorization or precertification, your Specialist is here to support you.

  • We can assist with the prior authorization or precertification process, providing you with the necessary forms for completion
  • We can also follow up with the insurance provider to determine the outcome

If the patient’s insurance company denies a prior authorization, precertification, or claim for the prescribed Celgene medication, Celgene Patient Support® can provide:

  • Information about the appeals process after a denied prior authorization, precertification, and/or claim
  • A checklist of the required documentation for submission to the insurance company
  • An appeal submission to the insurance company at the request of the patient and follow up on the status until a decision is reached

In order for Celgene Patient Support® to assist with the appeal, please provide the following information within 2 weeks of the insurance denial:

  • Copies of the front and back of the patient’s health insurance card(s), including a drug card or copy of patient’s information sheet clearly identifying insurance information, including phone numbers and claim submission address
  • Denial letter from payer
  • History and physical or consult letter and progress notes; and if applicable, related laboratory tests. Last 3 months needed
  • Letter of medical necessity; please include drugs tried and failed for this diagnosis. You can download information for letters of medical necessity here
  • Appointment of representative release form. This form allows us to assist the patient with the appeals process and can be downloaded here
* Celgene cannot provide insurance advice or make insurance decisions.
Celgene provides a facilitation service and will not provide any medical input into a prior authorization or an appeal.