Alimera Sciences is committed to
supporting your practice

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ILUVIEN Administration

  • Administration Guide (PDF)   administration-thumb
  • Optimal Use of ILUVIEN Applicator (PDF) optimal-use-thumb
  •  Play the Administration Video admin-guide-thumb
  •  Quick Reference Video: Understanding and Optimizing Use of the ILUVIEN Applicator iluvientraining

Patient Information

  • Summary Overview of AccessPlus (PDF)   accessplus-thumb
  • Patient Enrollment (PDF)   patientenrollment-thumb
  • Patient Brochure (PDF)   patientbrochure-thumb

AccessPlus: Streamlined reimbursement support services

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The ILUVIEN AccessPlus Program offers reimbursement support services with a streamlined process that is easily integrated into your patient processing system.

ILUVIEN AccessPlus supports your practice by offering comprehensive services built around your needs:

BENEFITS
INVESTIGATION
REIMBURSEMENT
SUPPORT
FINANCIAL ASSISTANCE
RESOURCES
PRODUCT ACQUISITION
FLEXIBILITY
To help you better understand
your patient’s health plan coverage for ILUVIEN
To provide guidance and assistance for patient
coverage scenarios
To help your patients with their out-of-pocket costs
for ILUVIEN
To provide acquisition and
access options best suited for your patient and practice

  • Patient-specific
    benefits investigation
  • Summary of Patient Benefits provided within 48 hours*
  • Prior authorization
    requirements with
    payer-specific process
    and forms provided
  • Patient out-of-pocket responsibility and  financial assistance options for ILUVIEN
    specified


  • Coding and billing guidance
  • Prior authorization
    assistance
  • Claims follow-up
  • Appeals support
  • Specialty pharmacy
    prescription referral routing and follow-up


  • ILUVIEN CoPay Program for commercially insured patients with a financial need
    • Patient out-of-pocket costs capped at $25
  • Referral to independent
    non-profit foundation for government-insured patients
    in need of copay assistance
  • ILUVIEN Patient Assistance Program provides free drug
    for qualified uninsured and rendered uninsured patients


  • Specialty Distributors for the buy-and-bill process
    • Besse Medical
    • McKesson Specialty Health
  • Specialty Pharmacy Network
  • Spoilage Replacement Program if ILUVIEN is prescribed per FDA label and you are unable to administer it

The ILUVIEN AccessPlus program is easy:

  • Prescribing physician enrolls one time with a simple, one-page Prescriber Enrollment Form
  • One-page Patient Enrollment Form
    • The enrollment form collects information needed for coverage coordination (benefits investigation, prior authorization, product acquisition options, financial assistance, claims support, and appeals support)
  • You receive a Summary of Patient Benefits for each patient benefits investigation with detailed information on ILUVIEN coverage for your patient

ILUVIEN AccessPlus is available to you:

By Phone: 1-844-445-8843, Option 3 AccessPlus Case Managers are available
Monday – Thursday, 8 AM EST – 7 PM EST
and Friday, 8 AM – 6 PM EST

Online: www.ILUVIEN.com/AccessPlus ILUVIEN.com offers reimbursement resources including downloadable enrollment forms, coding and billing guidance, ordering and product replacement information, and more.

By Fax: 1-844-501-7161

In Person: Dedicated Reimbursement Account Specialists are available to you, in person or by phone, to provide information about our resources for and reimbursement of ILUVIEN.

ICD-10 Coding

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Screen Shot 2017-03-27 at 2.17.00 PM The coding information discussed here is provided for informational purposes only, is subject to change, and should not be construed as legal advice. The codes listed here may not apply to all patients or to all health plans; providers should exercise independent clinical judgement when selecting codes and submitting claims to accurately reflect the services and products furnished to a specific patient.

Videos

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ILUVIEN Continuous MicrodosingTM Delivery System

 


AccessPlus Webcast

 


Administration Video

 


Quick Reference Video: Understanding and Optimizing Use of the ILUVIEN Applicator

 

Patient Support

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Patients with a financial need have several options to help cover the cost of ILUVIEN (fluocinolone acetonide).



ILUVIEN CoPay Program:

Eligible patients who have commercial or private insurance may qualify for assistance with out-of-pocket costs for ILUVIEN.

Download Brochure

No income eligibility requirement. No maximum assistance level.

The ILUVIEN CoPay Program provides assistance toward product-specific co-pay, co-insurance and insurance deductibles for ILUVIEN that exceed $25.

The patient is responsible for the first $25 of each treatment’s co-pay for ILUVIEN

Eligibility Requirements:

  • Patient must have commercial or private insurance that covers ILUVIEN for the FDA labeled indication
  • Patient out-of-pocket cost for ILUVIEN must exceed $25
  • Patient must provide household income and number in household
  • Patient must be a resident of the United States
*The program does not cover or provide support for procedures, supplies, or physician-related services associated with ILUVIEN. Only product-specific co-pay, co-insurance and insurance deductibles are covered.

This program is not valid where prohibited by law, taxed or restricted. Alimera Sciences reserves the right to change or cancel this offer or eligibility terms at any time without notice.

ILUVIEN CoPay Program Enrollment Options

ILUVIEN Patient Enrollment Form: Enter patient’s household income and number in household information on Page 2 when enrolling a patient with AccessPlus.

Phone: Your office or the patient may call AccessPlus at 1.844.445.8843, Option 3 to enroll.



Co-pay Assistance - Referral to a Foundation:

For patients who may need assistance with the out-of-pocket costs for ILUVIEN, AccessPlus can assist with the referral and application process to an independent co-pay assistance foundation when ILUVIEN is prescriber per the FDA-labeled indication.

Co-pay assistance foundations are independent organizations. Eligibility criteria are set by the foundation. Alimera Sciences does not control or influence the operations and cannot guarantee assistance will be provided.



Process for referral to a foundation:

ILUVIEN Patient Enrollment Form, Page 2:

  • Provide patient’s household income and number in household
  • Enter preferred foundation
  • Patient signs and dates “Applicant Authorization” section
  • Fax completed ILUVIEN Patient Enrollment form to AccessPlus at 1.844.501.7161

AccessPlus completes a benefits investigation for ILUVIEN and determines if a patient out-of-pocket responsibility is expected

If patient is insured by government-funded healthcare and is expected to have financial responsibility for ILUVIEN, AccessPlus will refer to the foundation of your choice and provide you with the application approval status and decision when available.



Independent Co-Pay Assistance Foundations with Macular Disease Funds:

Foundation Name
Phone NumberWebsiteHours of Operation
Good Days
(Chronic Disease Fund)
(877)968-7233www.mygooddays.orgMonday – Friday
8 am – 5 pm CST
Patient(888) 316-7263www.panfoundation.org
Monday – Friday
9 am – 5 pm EST


ILUVIEN Patient Assistance Program (PAP):

Provides ILUVIEN free of charge to eligible patients who are uninsured or lack coverage for ILUVIEN.

Eligibility Requirements:

  • Uninsured or lacks coverage for ILUVIEN
  • ILUVIEN must be prescribed per the FDA labeled indication.
  • Patient must be a resident of the United States
  • Patient must have a financial need
    Based on total adjusted annual household income of $100,000 or less

Patient must complete ILUVIEN Patient Assistance Program Application to be considered for the program.

  • Fax the completed and signed PAP application to AccessPlus at 1.844.501.7161
  • The application will be reviewed and an approval decision will be made within 5 business days.
  • The provider office and the patient will receive a letter with the approval status of the application.
  • AccessPlus will coordinate shipment of PAP ILUVIEN to your office upon approval of the patient application.
Application

Order ILUVIEN

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How to Order ILUVIEN

To order ILUVIEN, contact your distributor today:

Besse Medical Ophthalmology
888.767.7123 | View Besse online catalog
ILUVIEN Order No. 44083

McKesson Specialty Health
855-477-9800 | View McKesson's Ophthalmology site
ILUVIEN Order No. 5004970

Product Return and Replacement:

Alimera Sciences will replace product that is not usable at no charge.

Contact AccessPlus at 1.844.445.8843, Option 4

AccessPlus will obtain the information needed to initiate the product replacement request.

You will return the unusable product to Alimera Sciences using the shipping label provided during the replacement request process.

*For return and replacement of expired product:

Complete the ILUVIEN Expired Product Replacement Request Form

Download Form

Fax or email the completed form to Alimera Sciences

Fax Number: 1.404.529.4676

Email: customerservice@alimerasciences.com

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