Janssen CarePath

Savings Program

Express Enrollment

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Janssen CarePath Provider Portal

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  • Benefits investigations & prior authorizations
  • Enroll eligible patients in Savings Program
  • View Savings Program transactions

Benefits Investigation Support

Benefits Investigation Support

Need help? Call 877-CarePath (877-227-3728) Monday-Friday, 8:00 AM-8:00 PM ET

Access Support to Help Navigate Payer Processes

Janssen CarePath provides benefits information that may help your patients get the Janssen medication you may be considering for them. Contact us directly and get started today.

  • Investigation of patient eligibility and coverage:
    • Patient-specific benefits
    • Requirements for prior authorization process
    • Prior authorization support and status monitoring
  • Convenient electronic portal for online benefits investigations
  • Benefits summary available for physicians and staff
  • Information on payer policies and coverage for Janssen products
  • Information on the appeals process for administrative denials
  • Billing and coding information

Janssen CarePath Provider Portal

Verifying your patients' benefits is easy with the Provider Portal. The Janssen CarePath Provider Portal gives you 24-hour online access to request and review benefits investigations, request prior authorization support and status monitoring, request exceptions and appeals research, and enroll patients in the TREMFYA withMe Savings Program.

To get started

Create a Provider Portal account at JanssenCarePathPortal.com

  • Complete required information, include your practice locations, add administrators and staff to your site, and set communication preferences

Complete the Business Associate Agreement (BAA) for your practice (one time only)

  • The completed BAA allows you to use the Provider Portal without requiring individual patient authorization
    • You can execute the BAA within the Portal and receive immediate verification and access to the Portal, or
    • You can download the BAA and upload the signed document via the Portal or fax to the number provided on the form

OR

Secure patient authorization (for each patient)

  • Invite each patient to create an online account at MyJanssenCarePath.com to secure patient authorization, or
  • You can download the Patient Authorization Form at JanssenCarePath.com and upload the signed document via the Portal or fax to the number provided on the form

We cannot accept any information without an executed BAA or Patient Authorization on file.

If you have a BAA or Patient Authorization on file with us, please Sign Up for the Provider Portal at JanssenCarePathPortal.com.

Registered or returning Provider Portal users, Log In here.

Benefits Investigation

Download the Prescription Enrollment Form, complete, and submit to us via fax.*

TREMFYA® Prescription Enrollment Form (PEF)

*Janssen CarePath cannot accept any patient information without an executed BAA or individual patient authorization. In addition, a benefits investigation must be submitted for each patient for whom treatment with Janssen medication is requested.

Quick Guides to Understanding Verification of Benefits

Once your patient's benefits investigation is completed, you will receive either a Pharmacy Benefits or a Medical Benefits Verification of Benefits Form, depending on your patient's insurance coverage. Download a guide for help understanding the Verification of Benefits.

Guide to the Verification of Benefits (Medical Benefits)

Guide to the Verification of Benefits (Pharmacy Benefits)

Letter of Medical Necessity

Submit a letter to support the medical necessity of treatment with TREMFYA® either with the initial claim or when requesting reconsideration of a denied claim. Download an editable Letter of Medical Necessity template.

For patients who are continuing treatment in Delay and Denial Support, download an editable Letter of Medical Necessity (Reverification) template.

Prior Authorization Assistance

Our Prior Authorization (PA) Assistance includes:

  • Researching patient’s health plan for PA requirements
  • Providing payer-specific PA form for online completion by the provider in the portal
  • Monitoring status of the PA submission
  • Notifying your office 30 days before PA expiration

We do not fill out any information that requires the medical judgment of the prescriber, and only the prescriber can determine whether to pursue a PA.

A standardized, or "uniform," PA form may be required in certain states to submit PA requests to a health plan for review, along with the necessary clinical documentation. These standard forms can be used across payers and health benefit managers.

  • Standardized PA Forms are only applicable to prescription drug benefits; they are not applicable to medical services or procedures.
  • Standardized PA Forms are typically not applicable to self-funded employer-sponsored health plans, Medicare Part D plans, and Medicaid fee-for-service plans.

Please visit the Know Your State Interactive Tool to learn what is required for your state.

Information about your patient's insurance coverage, cost support options, and treatment support is given by service providers for Janssen CarePath. The information you get does not require you or your patient to use any Janssen product. Because the information we give you comes from outside sources, Janssen CarePath cannot promise the information will be complete. Janssen CarePath cost support is not for patients in the Johnson & Johnson Patient Assistance Foundation.

This information is not a promise of coverage or payment. It is not intended to give reimbursement advice or increase reimbursement by any payer. Legal requirements and plan information can be updated frequently. Contact the plan for more information about current coverage, reimbursement policies, restrictions, or requirements that may apply.

Collected in 6/22 and may change.

INDICATIONS

TREMFYA® (guselkumab) is indicated for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

TREMFYA® is indicated for the treatment of adults with active psoriatic arthritis.

 

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS
TREMFYA® is contraindicated in patients with a history of serious hypersensitivity reaction to guselkumab or to any of the excipients.

WARNINGS AND PRECAUTIONS

Hypersensitivity Reactions
Serious hypersensitivity reactions, including anaphylaxis, have been reported with postmarket use of TREMFYA®. Some cases required hospitalization. If a serious hypersensitivity reaction occurs, discontinue TREMFYA® and initiate appropriate therapy.

Infections
TREMFYA® may increase the risk of infection. Treatment with TREMFYA® should not be initiated in patients with a clinically important active infection until the infection resolves or is adequately treated.

Consider the risks and benefits of treatment prior to prescribing TREMFYA® in patients with a chronic infection or a history of recurrent infection. Instruct patients receiving TREMFYA® to seek medical help if signs or symptoms of clinically important chronic or acute infection occur. If a patient develops a clinically important or serious infection, or is not responding to standard therapy, closely monitor and discontinue TREMFYA® until the infection resolves.

Pre-Treatment Evaluation for Tuberculosis (TB)
Evaluate patients for TB infection prior to initiating treatment with TREMFYA®. Initiate treatment of latent TB prior to administering TREMFYA®. Monitor patients for signs and symptoms of active TB during and after TREMFYA® treatment. Do not administer TREMFYA® to patients with active TB infection.

Immunizations
Prior to initiating TREMFYA®, consider completion of all age-appropriate immunizations according to current immunization guidelines. Avoid use of live vaccines in patients treated with TREMFYA®.

ADVERSE REACTIONS

Most common (≥1%) adverse reactions associated with TREMFYA® include upper respiratory infections, headache, injection site reactions, arthralgia, bronchitis, diarrhea, gastroenteritis, tinea infections, and herpes simplex infections.

The overall safety profile observed in patients with psoriatic arthritis is generally consistent with the safety profile in patients with plaque psoriasis, with the addition of bronchitis and neutrophil count decreased.

 

Please read the full Prescribing Information and Medication Guide for TREMFYA®. Provide the Medication Guide to your patients and encourage discussion.

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