Benefits Investigation Support

Benefits Investigation Support

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

Access to the Information You May Need

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, provide prior authorization support and status monitoring, request exceptions and appeals research, and enroll patients in the Janssen CarePath Savings Program.

To get started

  1. Complete a Business Associate Agreement (BAA) for your practice one time only. The completed BAA allows you to request verification of patient benefits and enroll patients in the Janssen CarePath Savings Program without requiring individual patient authorization.
    OR
  2. Complete an individual Patient Authorization for each patient including the patient signature. Individual patient authorization is not required if BAA is on file.

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 Form

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

TREMFYA® Prescription Enrollment Form (PEF)

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. Click here for the sample letter.

Prior Authorization Assistance

On the phone or online, our Prior Authorization (PA) Assistance includes:

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

Uniform Prescription Drug Prior Authorization Request Form & Notification Requirements for Health Plans

Some health plans in select states must use their state's uniform prior authorization request form. Please contact Janssen CarePath at 877-CarePath (877-227-3728) for assistance in obtaining prior authorization forms.

Uniform Prior Authorization Information for Select States

Indication

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

TREMFYA® is administered as a 100 mg subcutaneous injection once every 8 weeks, after starter doses at weeks 0 and 4. TREMFYA® is intended for use under the guidance and supervision of a physician. Patients may self-inject with TREMFYA® after physician approval and proper training.

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Important Safety Information For TREMFYA®

Important Safety Information

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, diarrhea, gastroenteritis, tinea infections, and herpes simplex infections.

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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