Get the free Xermelo - Blue Cross Blue Shield of Arizona

PHARMACY COVERAGE GUIDELINES SECTION: DRUGSORIGINAL EFFECTIVE DATE: LAST REVIEW DATE: LAST CRITERIA REVISION DATE: ARCHIVE DATE:5/18/17 5/17/18 5/17/18XERMELO (telotristat ethyl) oral tablet Coverage

How to fill out xermelo - blue cross

How to fill out xermelo - blue cross

1. To fill out Xermelo - Blue Cross, follow these steps:
2. Gather all the necessary information and documents, such as your medical history, insurance information, and prescription details.
3. Contact your healthcare provider or physician for guidance on how to fill out the form correctly.
4. Read the instructions provided on the Xermelo - Blue Cross form carefully.
5. Start filling out the form by entering your personal information, including your name, date of birth, address, and contact details.
6. Provide your insurance information, including your policy number and group number.
7. Answer all the questions honestly and accurately, providing any necessary details about your medical condition or treatment.
8. If there are any specific sections related to Xermelo or Blue Cross coverage, make sure to fill them out accordingly.
9. Double-check all the information you have entered to ensure its accuracy.
10. If required, attach any supporting documents or prescriptions as instructed on the form.
11. Once completed, review the filled form one last time and make sure you haven't missed anything.
12. Submit the filled form to the appropriate recipient, such as your healthcare provider or insurance company, using the specified method (e.g., mail, fax, online portal).
13. Keep a copy of the filled form for your records.
14. Note: The steps mentioned above are general guidelines. It's important to refer to the specific instructions provided with the Xermelo - Blue Cross form for accurate and up-to-date information.

Who needs xermelo - blue cross?

1. Xermelo - Blue Cross is typically needed by individuals who meet certain criteria:
2. - Individuals diagnosed with carcinoid syndrome diarrhea, a condition associated with carcinoid tumors.
3. - Patients who have been prescribed Xermelo (telotristat ethyl) as part of their treatment for carcinoid syndrome diarrhea.
4. - Individuals who have Blue Cross insurance or coverage through Blue Cross.
5. It is crucial to consult with a healthcare provider and your insurance company to determine if Xermelo - Blue Cross is appropriate and covered for your specific medical condition and insurance plan.

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What is xermelo - blue cross?

Xermelo - Blue Cross is a medication used to treat a condition called carcinoid syndrome diarrhea in patients with neuroendocrine tumors.

Who is required to file xermelo - blue cross?

Healthcare providers are required to prescribe Xermelo - Blue Cross for eligible patients.

How to fill out xermelo - blue cross?

Xermelo - Blue Cross is filled out by the prescribing healthcare provider based on the patient's specific condition and dosage requirements.

What is the purpose of xermelo - blue cross?

The purpose of Xermelo - Blue Cross is to help manage diarrhea and other symptoms associated with carcinoid syndrome in patients with neuroendocrine tumors.

What information must be reported on xermelo - blue cross?

The information reported on Xermelo - Blue Cross includes the patient's name, dose instructions, and healthcare provider information.