Pediatric Endocrinology Associates
2 Dean Drive Suite 2
Tenafly, NJ 07670
phone: 201-871-4680 fax: 201-266-8839
STARTING GROWTH HORMONE
STEP 1: MAKE GROWTH HORMONE MEDICATION DECISION. You and the Doctor will choose a Growth Hormone (GH) medication that is best for your child based on her/his individual needs and insurance coverage.
*Please note: see the back page for GH websites to reference.
STEP 2: SUBMIT PRESCRIPTION AND OTHER REQUIRED DOCUMENTATION TO GH SUPPORT CENTER FOR INSURANCE BENEFITS APPROVAL. Doctor’s Office submits required documentation (including prescription) to the GH Company’s department and / or your insurer to determine coverage.
* Please note: this can take as little as a few days or up to a few months depending on the diagnosis, insurance plan, pharmacy benefits etc. See the table on the back page that provides the name of the companies and their contact information.
STEP 3: PARENT/GAURDIAN RETURNS INFORMATION TO GH SUPPORT CENTER. You will be proactively contacted by the GH Company’s support center to verify the following information:
- Your insurance/pharmacy benefits
- Your permission to start GH therapy during the insurance benefits investigation
***Please note: Not ALL GH companies operate the same. Some may ask for authorization from you that requires a signature. Your prompt attention to the communications of these support centers is VERY important. It will determine how quickly your child can get started using their GH medication. If you receive an unfamiliar phone call with limited information it could be the GH company’s support center. Many are unable to leave too much detail (patient privacy information) on voicemail however, If in doubt, you may call the office to confirm that you are trying to be reached by the support call center.
STEP 4: YOU RECEIVE “START UP” THERAPY WHILE WAITING FOR INSURANCE COMPANY APPROVAL. Not all GH companies work the same. Some have “start up” therapy while others do not. You will be able to find out the policy of your chosen GH medication when interacting with their respective GH support center. At this stage you will do the following:
- Set up medication delivery
- Schedule training with a home nurse
- Please Note: Each GH Company has different ways to set up trainings but these are at *NO COST TO YOU OR YOUR INSURANCE * See back table for training numbers to call for each GH Medication
|STEP 5: THE INSURANCE COMPANY MAKES A DECISION TO APPROVE OR DENY YOUR CHILD’S GH MEDICATION.
One of two scenarios will occur:
|YOU ARE APPROVED:
|YOU ARE NOT APPROVED (Denial):
|If your child is approved you will receive information from the GH company’s support center letting you know the following:
· Specialty Pharmacy that will deliver your GH Medication
· How to receive training (if you did not already receive early start treatment)
|Depending on your insurance company, your individual policy and the child’s diagnosis you may have some choices that require additional documentation to conduct the following:
· Appeal (in some cases multiple)
· Patient Assistance
STEP 6: YOU RECEIVE ONGOING MEDICATION / TREATMENT. Your specialty pharmacy or the manufacturer’s pharmacy will deliver your medication on a monthly or quarterly basis depending on your plan. (This pharmacy may be different from the original one that sent your meds in the beginning of therapy.)
*LOOK ON BACK FOR MORE INFORMATION*
|GROWTH HORMONE COMPANY WEBSITES
|FEATURES TO CONSIDER
· Ease of Use
· Co-Pay Assistance
· Patient Assistance
· Patient Support
|GROWTH HORMONE COMPANY SUPPORT CENTERS
|SUPPORT CENTER NAME
|SUPPORT CENTER CONTACT INFO
|Pfizer Bridge Program
|Humatrope Reimbursement Center (HRC)
|Nordicare Support Services
|Connections for Growth
|DO YOU NEED GH MEDICATION TRAINING?
|IS YOUR DEVICE MALFUNCTIONING?
|TRAINING CONTACT INFO
For some companies you need to call the support centers listed above
*Ask to be trained by Rachel, Jo Anne or Martha Feldheim (Humatrope only) *