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CONTACT US

Important Numbers:
Voice: 1-866-AMG-ASST
  (1-866-264-2778)
Fax: 1-877-877-6542

Monday - Friday
9:00AM-8:00PM ET
Mailing Address:
Amgen Assist®
PO Box 220807
Charlotte, NC 28222-0807

Forms

Materials to Assist You With Accessing Prolia® for Your Patients


Insurance Verification Request

Insurance Verification Request Form
Amgen Assist® can work directly with insurers to help verify patient coverage and out-of-pocket costs for Prolia®. Amgen Assist® communicates insurance verification results directly to your office and, if requested, to your patients. To request Amgen Assist® assistance for an individual patient, either complete the Insurance Verification Request form and fax it to Amgen Assist® at 877-877-6542 or register for Amgen Assist® Support Portal to submit requests through the Internet.

Additional Resources

Coding & Billing
This informational resource can be used to understand how to complete the CMS 1500 form for physician offices. For additional information in completing the CMS 1500 form and for payer specific requirements, please contact Amgen Assist® at 866-AMG-ASST (866-264-2778).

Claims
Amgen Assist® can work directly with insurers to track claims for Prolia®. To request claims tracking assistance, complete the Claims Tracking Form and fax to Amgen Assist® at 877-877-6542.

Sample Letter of Appeal
If a claim is denied for your patient, this sample letter provides a template and guidance on type of information to include to effectively appeal the denial.

Sample Letter of Medical Necessity
If the patient's health plan requires additional support to demonstrate medical necessity, this sample letter provides a template and guidance on type of information to include to effectively make the request.

Preferred Distributors

Preferred Distributors
You can take an active role in preventing counterfeit drugs by ensuring that you source products only from an Amgen Authorized Wholesaler. Amgen Authorized Wholesalers (also known as authorized distributors of record) may only purchase Amgen products directly from Amgen. Amgen Authorized Wholesalers share our commitment to patient safety. You can best serve your patients by purchasing Amgen products only from our Authorized Wholesalers.