Find the right resources to assist your FASENRA patients

FASENRA Overview of Key Steps

A single-page overview of the key steps for obtaining FASENRA.

FASENRA Enrollment Form

A multi-page enrollment form to capture necessary patient, provider, and prescription information to start a new request for support.

FASENRA Savings Program Affordability Information

A two-page resource describing ways in which patients can pay for FASENRA if it is approved or denied.

FASENRA Coding Resource

This resource provides specific codes related to diagnosing and billing for FASENRA. FASENRA J-Code: J0517

The Policy Acumen Portal provides up-to-date resources for billing, coding, and coverage policies specific to FASENRA for preselected payers.

Click here to learn more.

FASENRA Access and Reimbursement Guide

This guide contains general information on dosing, distribution, support services, and reimbursement for FASENRA.

FASENRA Distribution Sheet

This sheet provides the contact information of authorized Specialty Pharmacy Providers and Specialty Distributors, from which FASENRA can be obtained.

FASENRA Prior Authorization and Appeal Checklist

Checklists designed to be used as a reference during the prior authorization (PA) and denial/appeal processes for FASENRA.

Click here to watch a short video about Prior Authorization and Appeals.

FASENRA Sample Letter of Medical Necessity

This template is offered as a resource a healthcare provider could use when responding to a request from a patient’s insurance company to provide a letter of medical necessity for prescribing FASENRA.

FASENRA Sample Appeal Letter

This template can be used by a healthcare provider to appeal a denial of access to FASENRA.

FASENRA Sample Letter of Appeal – Low Count

This template can be used by a healthcare provider to appeal a denial of access to FASENRA.

FASENRA Sample Letter of Appeal – Product Change

This template can be used by a healthcare provider to appeal a denial of access to FASENRA.

FASENRA Sample Plan Exception Request Letter

This template is a sample resource a healthcare provider could use when requesting a plan exemption for FASENRA from a patient's insurance company.

FASENRA Sample Renewal Authorization Letter

This template can be used by a healthcare provider when responding to a request to submit a renewal authorization for a patient who has been receiving FASENRA.

FASENRA Denied Patient Savings Program Form

A single-page form for patients who have been denied FASENRA.

FASENRA Technology Information

An overview of technology resources for managing your FASENRA patients.

FASENRA Patient Injection Record

A log for you to keep track of injections administered to your FASENRA patients.

Benefit Investigation Report

This piece provides an overview of the benefit investigation conducted by Access 360.

Understanding Medicare Brochure

This brochure explains Medicare Parts A, B, C, and D, key terms commonly used, and prescription coverage within Medicare Part D. It also provides an overview of the current Medicare Coverage Gap.

Denial Management Guide

This guide provides you with resources and information to ensure you have all the tools you need to help navigate the denial of an AstraZeneca medicine.

Access 360 HCP Portal Brochure

This guide provides you with information to help navigate the Access 360 HCP Portal.