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About The Patient Assistance Program

The CSL Behring Patient Assistance Program provides medically necessary therapies to qualified patients who are uninsured, underinsured, or for those individuals who cannot afford their prescribed therapy.

Enrollment

Upon reviewing the case with one of our staff members and determining that assistance is warranted, the CSL Behring Department of Reimbursement Services will send a Program Qualification Form to be completed by both you and your attending physician. Once the necessary forms have been completed and returned to our office, the CSL Behring Reimbursement Services and Medical Affairs Departments will determine eligibility for participation in our program. Qualified patients may receive up to a 3-month supply of a CSL Behring product. At the end of 3 months, the patient’s eligibility is re-evaluated for continued participation in the program if needed.

Forms to be Completed

Athough forms are a necessary requirement of all Patient Assistance Programs, enrollment into the CSL Behring Patient Assistance Program only requires the following information:

1. A completed Patient Assistance Qualification Form

2. The brand name prescription for medication

3. A letter from the physician with the following patient information:

  • Name
  • Complete mailing address 
  • Date of birth
  • Social security number
  • Diagnosis
  • Insurance status
  • Insurance synopsis (reason for need and description of other attempts made to access alternate coverage)

Unlike other programs that require routine submission of forms, the CSL Behring Patient Assistance Program only requires completion of these forms when the need arises.

Contacting the CSL Behring Patient Assistance Program

Call the CSL Behring Reimbursement Services Department at 1-800-676-4266 between the hours of 8:00 am – 5:00 pm (ET), Monday through Friday to receive enrollment forms or to ask any questions about the program.

CSL Behring reserves the right, at its sole discretion, to discontinue the Patient Assistance Program at any time. All patient information remains confidential. Product supply for the program depends upon availability.

Assistance in Obtaining Insurance Coverage

A list of sites that are a direct link to insurance coverage options relative to chronic disorders.

Insurance Appeals Process

A description of the appeal process that shows the necessary steps and the proper organization needed to file an appeal or grievance.

MTL07-12-0002 10/2012
© 2014 CSL Behring