Get the free ABRAXANE® Benefit Verification Request Form

This form is used to verify patient benefits for ABRAXANE® for Injectable Suspension. It requires comprehensive information from both the physician and the patient, and can be submitted via fax or

How to fill out abraxane benefit verification request

How to fill out ABRAXANE® Benefit Verification Request Form

1. Obtain the ABRAXANE® Benefit Verification Request Form from the official website or your healthcare provider.
2. Fill in the patient's personal information, including their name, date of birth, and insurance details.
3. Provide the prescribing physician's information, including their name and contact details.
4. Indicate the medical necessity of ABRAXANE® and the diagnosis for which it is prescribed.
5. Include any relevant medical records or documentation that support the need for ABRAXANE®.
6. Review the completed form for accuracy and completeness.
7. Submit the form to the appropriate insurance company or benefits administrator as instructed.

Who needs ABRAXANE® Benefit Verification Request Form?

1. Patients who have been prescribed ABRAXANE® for cancer treatment.
2. Healthcare providers who require verification of benefits for their patients.
3. Insurance companies that need to assess coverage for ABRAXANE® prescriptions.

People Also Ask about

Can ABRAXANE be given weekly?

Conclusions: Preliminary data show that Abraxane given weekly at 125 mg/m2 (with or without Herceptin) for first-line treatment of MBC is well tolerated. Patient accrual continues in this study. Updated analysis of this study will be provided at the meeting.

How often is Abraxane given?

The recommended regimen for ABRAXANE is 260 mg/m2 administered intravenously over 30 minutes every 3 weeks.

What is Abraxane approved for?

Abraxane is a chemotherapy drug used to treat advanced-stage cancer. It works by slowing down or stopping the growth of cancer cells. It's often used by itself but is sometimes used with other chemotherapy medicines, or after other post-surgery chemotherapy medicines have stopped working.

How many cycles of ABRAXANE?

If given on Day 1 only, it is usually repeated every 21 days and called a "single-dose cycle." If given on Days 1, 8, and 15 it is called a "three-dose cycle" and repeated every 28 days. Each cycle may be repeated until the drug stops working or until unacceptable side effects occur.

Is ABRAXANE a strong chemo?

Abraxane (chemical name: albumin-bound or nab-paclitaxel) is a taxane chemotherapy drug. Taxanes are powerful chemotherapy medicines that interfere with the ability of cancer cells to divide, stopping the cells from repairing themselves or making new cells.

What is Abraxane patient info?

ABRAXANE will be given to you by intravenous (IV) infusion into your vein. Your healthcare provider should do blood tests regularly during treatment with ABRAXANE. Your healthcare provider may stop your treatment, delay your treatment, or change your dose of ABRAXANE if you have certain side effects.

Who makes Abraxane?

In an Oct. 31 warning letter addressed to BMS helmsman Giovanni Caforio, the FDA dinged Abraxis Bioscience—acquired by Bristol Myers' Celgene in 2010—for a raft of production issues tied to the companies' billion-dollar cancer med Abraxane.

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What is ABRAXANE® Benefit Verification Request Form?

The ABRAXANE® Benefit Verification Request Form is a document used by healthcare providers to confirm the insurance coverage and benefits for patients prescribed ABRAXANE®.

Who is required to file ABRAXANE® Benefit Verification Request Form?

Healthcare providers, such as physicians or their office staff, are required to file the ABRAXANE® Benefit Verification Request Form on behalf of their patients.

How to fill out ABRAXANE® Benefit Verification Request Form?

To fill out the ABRAXANE® Benefit Verification Request Form, you need to provide patient information, insurance details, prescribing physician’s details, and other relevant medical information as prompted on the form.

What is the purpose of ABRAXANE® Benefit Verification Request Form?

The purpose of the ABRAXANE® Benefit Verification Request Form is to facilitate the verification of insurance benefits for the drug ABRAXANE®, ensuring that patients can receive the medication without undue delay.

What information must be reported on ABRAXANE® Benefit Verification Request Form?

The information that must be reported includes the patient’s demographics, insurance policy information, the name of the prescribing physician, diagnosis, and the requested treatment details related to ABRAXANE®.