Benefits Investigation Support
Benefits Investigation Support
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:
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
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 at JanssenCarePath.com and upload the signed document via the Portal or fax to the number provided on the form
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.
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.
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 (editable).
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
† 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 prior authorization.
Online resource for PA support is available at JanssenCarePathPortal.com.
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
Patient insurance benefits investigation and other Janssen CarePath program offerings are provided by third-party service providers for Janssen CarePath, under contract with Johnson & Johnson Health Care Systems Inc. on behalf of Janssen Pharmaceuticals, Inc., Janssen Biotech, Inc., and Janssen Products, LP (Janssen). Janssen CarePath is not available to patients participating in the Patient Assistance Program offered by Johnson & Johnson Patient Assistance Foundation. The availability of information and assistance may vary based on the Janssen medication, geography and other program differences. Janssen CarePath assists healthcare providers (HCPs) in the determination of whether treatment could be covered by the applicable third-party payer based on coverage guidelines provided by the payer, and patient information provided by the HCP under appropriate authorization following the provider's exclusive determination of medical necessity. This information and assistance are made available as a convenience to patients, and there is no requirement that patients or HCPs use any Janssen product in exchange for this information or assistance. Janssen assumes no responsibility for and does not guarantee the quality, scope, or availability of the information and assistance provided. The third-party service providers, not Janssen, are responsible for the information and assistance provided under this program. Each HCP and patient is responsible for verifying or confirming any information provided. All claims and other submissions to payers should be in compliance with all applicable requirements.