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Provide your patients comprehensive access-related support

PERMANENT J CODE

Effective: 10/1/2021

HCPCS Level II code1:

J1448 Injection, trilaciclib, 1 mg

Patient Support Program
Call us with questions at 1-833-418-6663, fax to 1-833-329-4121, or email us at enroll@COSELAcares.com
Your Resource for Access and Affordability Solutions

COSELA CaresTM offers a suite of solutions to help you address access and reimbursement hurdles:
Benefits verification to confirm patient coverage and out-of-pocket responsibilities
Payor-specific guidance for prior authorizations and appeals
Assistance navigating insurance-related delays or coverage denials
Providing resources that connect eligible patients, regardless of insurance type, to appropriate support options for high deductibles, copays, or coinsurance*
Help eligible patients who meet program criteria access COSELA treatment and support resources
*
COSELA CaresTM provides informational support only and does not submit claims or perform administrative services on behalf of providers. Program participation does not guarantee insurance coverage, product access, or reimbursement.
Eligibility and restrictions apply.
Healthcare Nurse and Patient

Simple COSELA Cares™ Enrollment Process

Call us with questions at 1-833-418-6663, fax to
1-833-329-4121, or email us at enroll@COSELAcares.com

Enrollment Form

Complete and submit the form to enroll patients in COSELA Cares™

Fax the form to
1-833-329-4121

Submitting the completed form will initiate a benefits investigation that includes coverage status, prior authorization requirements, and patient out-of-pocket costs. This information will be provided to your practice.

Enrollment does not guarantee benefits.

Submitting the completed form will initiate a benefits investigation that includes coverage status, prior authorization requirements, and patient out-of-pocket costs. This information will be provided to your practice.

Enrollment does not guarantee benefits.

Resources to Make Coverage and Reimbursement Easier