Patient Enrollment
Healthcare providers (HCPs) may electronically enroll a patient in INSUPPORT by going to www.insupportportal.com.
This form is used to enroll a patient in INSUPPORT. Start by selecting the program option(s) requested by the patient and complete the required steps outlined on the Form. Please ensure that the patient reads, understands, signs, and dates the Patient Authorization page of the Patient Enrollment Form. This form is also available in Spanish.
This form will provide additional information on completing an INSUPPORT Patient Enrollment Form.
Patient Authorization is required for INSUPPORT to initiate any enrollment request. If the authorization is not completed as part of the Patient Enrollment Form while the patient is in the office, patients may provide authorization to INSUPPORT electronically via the INSUPPORT Portal.
This resource provides an overview of functionality available for healthcare providers (HCPs) and patients who use the INSUPPORT Portal to provide information to INSUPPORT electronically.
Benefit Coverage Information
INSUPPORT can research the patient's insurance benefits for SUBLOCADE® (buprenorphine extended-release) injection, for subcutaneous use, CIII, for patients enrolled in Benefit Coverage Information with INSUPPORT. This resource provides detailed information about the Final Benefit Summary from INSUPPORT.
This sample letter offers examples of additional information that may be helpful when requesting a reevaluation of a patient's denial for SUBLOCADE coverage by the insurance provider.
This sample letter offers examples of additional information that may be required by an insurance provider to demonstrate that treatment with SUBLOCADE is warranted, appropriate, and medically necessary.
*These annotated samples and samples are intended for informational purposes only and not for direct use as a Patient Enrollment Form, Benefit Summary, Letter of Appeal or Letter of Medical Necessity.
Acquisition of SUBLOCADE
Specialty Pharmacy Pathway
INSUPPORT offers a list of specialty pharmacies that dispense SUBLOCADE.
This flashcard provides a step-by-step guide to the specialty pharmacy process, as well as an overview of the information INSUPPORT can provide to practices in using the specialty pharmacy pathway.
Buy and Bill Pathway
INSUPPORT offers a list of specialty distributors that distribute SUBLOCADE.
This flashcard provides a step-by-step guide to the buy and bill process, as well as an overview of the information INSUPPORT can provide to practices in using the buy and bill pathway.
This flashcard provides a checklist of some considerations for HCPs who are contemplating the buy and bill pathway for SUBLOCADE.
Additional Site of Care Pathway
This flashcard provides an overview of how the additional site of care (ASOC) pathway may provide a flexible option for the administration of SUBLOCADE injections.
This guide provides an overview of how the additional site of care (ASOC) pathway may provide a flexible option for the administration of SUBLOCADE along with steps to locate an ASOC using resources on INSUPPORT.com
This form may be used by prescribing healthcare providers to refer patients seeking SUBLOCADE administration at additional sites of care.
Reimbursement Information
This guide provides information on SUBLOCADE billing and coding for claims submissions to the patient's insurance provider.
Copay Assistance
This document provides details about the eligibility requirements for patients to enroll in and receive benefits under the INSUPPORT Copay Assistance Program. It also outlines the program's benefits and conditions.
This brochure provides detailed information about the INSUPPORT Copay Assistance Program for SUBLOCADE.
Learn more about the INSUPPORT Copay Assistance Program claim reimbursement process.
Transition of Care
This form is intended to enroll justice-involved patients who are in the process of transitioning to a new provider. By using this form, a patient may engage INSUPPORT® transition of care offerings.
The purpose of this form is to enroll justice-involved patients who have recently been released and are experiencing a gap in health insurance coverage. By using this form, patients can determine eligibility to receive up to 2 months of SUBLOCADE® at no cost during their coverage gap.
This brochure provides an overview of the information and processes associated with Transition of Care Support for enrolled patients.
This resource is designed for residential treatment centers to understand and appropriately navigate access for SUBLOCADE.
The Substance Abuse and Mental Health Services Administration (SAMHSA) also provides treatment information. Go to https://findtreatment.samhsa.gov to find a facility near your patient that can provide treatment based on patient-specific criteria. Steps for using SAMHSA's Treatment Services Locator.
For patients who are transitioning to a new healthcare setting for the treatment of SUBLOCADE, this card can be given to the patient to provide important information on next steps such as the patient's next injection due date, the new provider's contact information and appointment information, if applicable.
This guide provides a comprehensive overview of the resources published by various agencies to aid applications in grant writing for Opioid Use Disorder (OUD) programs.
Find a SUBLOCADE Treatment Provider
INSUPPORT can assist in locating a SUBLOCADE treatment provider near your patient or additional sites of care where the patient may receive administration of SUBLOCADE. If you are a SUBLOCADE treatment provider and would like to be included in the Indivior Find a SUBLOCADE Treatment Provider Tool or modify your existing listing, visit ListMyPractice.com.
Additional Sites of Care
An Additional Sites of Care (ASOC) is a facility or healthcare provider (HCP), other than a prescribing physician's office, that may provide a flexible option for the administration of SUBLOCADE injections. You may prefer patients receive SUBLOCADE at a facility other than your practice, while you continue to manage their overall care.
Provider
A Provider is someone who works as a physician, nurse practitioner, or physician assistant, and has prescribed SUBLOCADE at least once in the previous two years, and has elected to be included in this tool.
†This free tool provides a list of physicians, nurse practitioners, and physician assistants who have the required legal permissions to treat opioid dependence with FDA-approved medications, have prescribed SUBLOCADE® (buprenorphine extended-release) at least once in the previous two years, and have agreed to be included in the Indivior Find a SUBLOCADE Treatment Provider Tool. This tool may also be used to identify additional sites of care where patients who have been prescribed SUBLOCADE can go to receive treatment.
General Information
Find a Patient Access Specialist (PAS)
This resource will aid in finding a local PAS to provide in-person information to the HCP office.
This brochure provides an overview of the INSUPPORT Program.
Offers a format that HCP offices may use to record important dates, reminders or next steps along a patient’s access journey to SUBLOCADE.
This webpage provides HCP offices with information on key steps typical of a patient's access journey to receiving SUBLOCADE.
For the Patient
Appropriate eligible patients can enroll online in the INSUPPORT Copay Assistance Program for SUBLOCADE.
This brochure provides patients with detailed information about INSUPPORT.
This brochure provides patients and caregivers with an overview of information and processes associated with Transition of Care Support for enrolled patients.
This is a glossary to help patients understand common insurance terms.
Is your information listed on the Find a SUBLOCADE Treatment Provider Tool?
Include your information on the list of SUBLOCADE treatment providers*. If you would like to be listed on or removed from the Find a SUBLOCADE Treatment Provider Tool, you can choose to complete the opt-in form or change request/opt-out form.
To list your practice, to update your existing contact information, or to remove your listing, visit ListMyPractice.com.
LISTMYPRACTICE.COM
*
This free tool provides a list of physicians, nurse practitioners, and physician assistants who have the required legal permissions to treat opioid dependence with FDA‑approved medications, have prescribed SUBLOCADE at least once in the previous two years, and have agreed to be included in the Indivior Find a SUBLOCADE Treatment Provider Tool.
The Substance Abuse and Mental Health Services Administration also provides information on treatment facilities at https://findtreatment.samhsa.gov/.