Hematology Support Center (HSC) benefits verification form

Getting an HSC benefits verification started for your patient is easy:

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Simply fill out, sign, and fax the enrollment form.

 
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Fax the completed form along with a copy of the front and back of your patient's insurance card(s).

 
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Fax to 1-866-467-77401-866-467-7740.

Educational materials for your office

Download the following resources to help your patients get access to their prescribed Takeda therapy when potential insurance challenges arise.

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PA Request Form Checklist

Use this checklist when preparing prior authorization and reauthorization paperwork.

Use this checklist when preparing prior authorization and reauthorization paperwork

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PA Appeals Checklist

Use this checklist to help you prepare an appeals letter.

Use this checklist to help you prepare an appeals letter.

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Hematology Coverage and Reimbursement Resource

This guide offers information to help you navigate and respond to appeals and denials for Takeda hematology product coverage.

This guide offers information to help you navigate and respond to appeals and denials for Takeda hematology product coverage.

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Sample Letters of Medical Necessity

HSC provides sample Letters of Medical Necessity for specific Takeda hematology therapies. You can find them by visiting the Product Information and Coding section.

HSC provides sample Letters of Medical Necessity for specific Takeda hematology therapies. You can find them by visiting the Product Information and Coding section.

Patient resources

Find links, worksheets, and guides to help your patients understand their bleeding disorder and the complex landscape of health insurance.

Disease education and patient advocacy

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BleedingDisorders.com

Information to help patients learn about bleeding disorders and connect with others.

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Centers for Disease Control and Prevention (CDC)

Insightful articles and free downloads from the CDC.

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National Hemophilia Foundation (NHF)

Tools and resources to help patients self-advocate and connect with others.

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Centers for Disease Control and Prevention (CDC): Find a Hematology Treatment Center (HTC) near you

You can find an HTC near you by visiting the CDC's website.

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Hemophilia Federation of America (HFA)

Provides the latest news about bleeding disorders, resources for navigating insurance, advocacy tools, and more.

Insurance worksheets and informative guides

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My Policy
Details

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Health Insurance
Comparison Worksheet

The Affordable Care Act and You

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The End of Lifetime Caps

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Additional resources for patients on Medicare, Medicaid, and other public plans

The Centers for Medicare and Medicaid Services (CMS)

Veterans Health Administration

Need Assistance?

Call us: 1-888-229-83791-888-229-8379

Monday-Friday 8:30 AM to 8:00 PM ET

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