Because Increlex (mecasermin [rDNA origin] injection) is a new treatment option, there may exist some initial uncertainty surrounding reimbursement. To help you with insurance coverage, Tercica has implemented a reimbursement support program called TerciCare. TerciCare will assign a personal case manager to handle insurance and paperwork for you and help answer questions you might have.

PLEASE FOLLOW THESE STEPS FOR REIMBURSEMENT:

Step 1

During your office visit, fill out the statement of medical necessity (SMN) with your doctor. Be sure your doctor fills out the prescription at the bottom of the form and make sure a parent or legal guardian signs the patient consent and authorization form.

Step 2

Your doctor will via fax send the patient's growth chart, lab results, and all other necessary medical documentation to TerciCare at 1-800-548-7036. Upon receipt, a case manager will be assigned to assist you and your doctor throughout the reimbursement and treatment process.

Step 3

Your TerciCare case manager submits all paperwork for reimbursement and remains in contact with you and your doctor as the process moves forward.

Step 4

TerciCare notifies the designated specialty pharmacy to send a free 30-day Starter Care kit to your home or your doctor's office—whatever is specified on the Increlex SMN. If there are delays in the approval process, TerciCare may grant as-needed extensions of the free 30-day supply.

Step 5

If the patient's condition or coverage changes for any reason, your doctor will be notified if updated clinical information is needed.

Our priority is to see that your child's therapy begins promptly and is not interrupted. If clinical updates are supplied accurately and completely, we can assure you of our best efforts to keep your child supplied with Increlex, and your doctor's office informed throughout treatment.

If you have any questions, you can reach your TerciCare case manager by calling:
1-866-TERCICA (1-866-837-2422)
and pressing option #3.

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