YOUR SOURCE FOR SUPPORT TO GET PATIENTS TIMELY ACCESS TO SKYRIZI
SKYRIZI COMPLETE ENROLLMENT
Ready to enroll your patient in Skyrizi Complete and start the process?
BILLING AND CODING
Clear guidance on billing and coding for SKYRIZI, including NDC codes.
ACCESS AND REIMBURSEMENT
Forms and instructions to help patients with access and coverage.
Specialty Pharmacies and Distributors
Contact details for specialty pharmacies, wholesalers and specialty distributors.
This information is for informational purposes only and is not intended to provide reimbursement or legal advice. The information presented here does not guarantee payment or coverage.
SKYRIZI COMPLETE ENROLLMENT
SKYRIZI COMPLETE ENROLLMENT AND PRESCRIPTION FORM
- Download and fill out the Skyrizi Complete Enrollment and Prescription Form with your patient.
- After submitting the form, your patient will receive a call from a Nurse Ambassador* within one business day. The call may come from any area code.
*Nurse Ambassadors are provided by AbbVie and do not provide medical advice or work under the direction of the prescribing healthcare professional (HCP). They are trained to direct patients to speak with their HCP about any treatment-related questions, including further referrals.
*Nurse Ambassadors are provided by AbbVie and do not provide medical advice or work under the direction of the prescribing healthcare professional (HCP). They are trained to direct patients to speak with their HCP about any treatment-related questions, including further referrals.
BILLING AND CODING
Single-dose Vial
600 mg/10.0 mL
0074-5015-01
Carton of 1
Single-dose Prefilled Cartridge
With On-Body Injector (OBI) 180 mg/1.2 mL
0074-1065-01
Kit
Single-dose Prefilled Cartridge
With On-Body Injector (OBI) 360 mg/2.4 mL
0074-1070-01
Kit
ACCESS AND REIMBURSEMENT FORMS
Along with support from Skyrizi Complete, you can use the forms here to help patients with access and coverage for SKYRIZI.
APPEALS LETTER SAMPLE
Appeal a denied claim for SKYRIZI.
FORMULARY EXCEPTION LETTER
Request a formulary exception to allow coverage for SKYRIZI.
HIPAA AUTHORIZATION
Allow patients to authorize the release of health information related to their treatment with SKYRIZI.
LETTER OF MEDICAL NECESSITY
Establish the medical necessity of SKYRIZI.
TIERED EXCEPTION LETTER
Request lower cost sharing for SKYRIZI as a preferred medication.
SKYRIZI IV REIMBURSEMENT DETAILS FORM
Assist eligible, commercially insured patients with IV & administration costs.
FOR SUPPORT IN PERSON OR OVER THE PHONE, CALL YOUR ACCESS SPECIALIST AT 1.877.COMPLETE (1.877.266.7538)
SPECIALTY PHARMACIES AND DISTRIBUTORS
LOOKING FOR MORE RESOURCES?
Streamline the Rx process for patients with CompletePro.com. You can help patients by:
- Digitally enrolling patients into Skyrizi Complete, giving them access to important resources like a Nurse Ambassador*
- Requesting medical and/or pharmacy benefit verifications and completing the prior authorization
- Sending prescriptions to the patient’s specialty pharmacy of choice with the option of including a savings card (if eligible)
- Receiving alerts when a prior authorization is going to expire and be informed of insurance changes in the new year
- Using the Reimbursement Portal to submit, manage, and view claims for patient reimbursement for infused patients
- Tracking where patients are in the prescription process
*Nurse Ambassadors are provided by AbbVie and do not provide medical advice or work under the direction of the prescribing health care professional (HCP). They are trained to direct patients to speak with their HCP about any treatment-related questions, including further referrals.
USE THESE GUIDES AND BEST PRACTICES TO HELP GET PATIENTS TIMELY ACCESS TO SKYRIZI
SKYRIZI COMPLETE ENROLLMENT
TREATMENT VIDEOS
ADDITIONAL RESOURCES
The resources on this page are provided for informational purposes only and are not intended as reimbursement or legal advice. The information presented here does not guarantee payment or coverage.
SKYRIZI COMPLETE ENROLLMENT
SKYRIZI COMPLETE ENROLLMENT AND PRESCRIPTION FORM
- Download and fill out the Skyrizi Complete Enrollment and Prescription Form with your patient.
- After submitting the form, your patient will receive a call from a Nurse Ambassador* within one business day. The call may come from any area code.
*Nurse Ambassadors are provided by AbbVie and do not provide medical advice or work under the direction of the prescribing healthcare professional (HCP). They are trained to direct patients to speak with their HCP about any treatment-related questions, including further referrals.
TREATMENT VIDEOS
Introduction to Infusion
A video guiding patients on how to prepare for their SKYRIZI infusion.
Injection Training
A video guiding patients on how to inject SKYRIZI using the On-Body Injector (OBI).
ADDITIONAL RESOURCES
Benefits Verification Checklist
Helps patients confirm their insurance coverage and out-of-pocket costs.
INSURANCE COMPARISON
Simple steps to help patients choose their insurance coverage when it's time to pick a plan.
PATIENT BROCHURE
Provides patients with an overview of how SKYRIZI works, including key efficacy, safety, and dosing information.