Reimbursement Services

KRYSTEXXA Connect offers information to help you understand insurer coverage and reimbursement for KRYSTEXXA® (pegloticase) Injection, 8 mg/mL, for Intravenous Infusion.

Additionally, this program offers support to help your patients access KRYSTEXXA therapy if they lack insurance.

Insurance Verification

Reimbursement hotline staff can conduct patient-specific research with insurers to confirm coverage for KRYSTEXXA and its infusion, including coverage requirements and patient benefit level (such as co-payment and out-of-pocket obligation).

  • All investigations include two independent verifications of the patient’s benefits with  their health plan
  • Most investigations are completed within 24 hours
  • In the event that a patient has not met the plan’s eligibility requirements for KRYSTEXXA therapy, re-verifications can be conducted as needed or at regularly scheduled intervals per your direction

Enrollment Form



enrollment-form

Prior Authorization

Reimbursement Specialists are available to conduct research with your patient’s health plan to confirm prior authorization requirements and facilitate submission and approval of prior authorization, including follow-up to confirm status. Patient cases requiring re-certification are queued for follow-up at the appropriate time.

Sample Letter of Medical Necessity



letter-medical-necessity

Coding and Reimbursement Inquiries

Knowledgeable staff members can provide up-to-date information on coding, billing, and payment information related to Krystexxa and its infusion.

Detailed Coding
Information

detailed-coding-information

Important Phone
Numbers

important-phone-numbers