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Committed to you and your patients

Providing Comprehensive Support

Benefits Investigation

A full report, including insurance coverage, within 2 business days.

Claims Assistance

Helping address your questions up front. Receive coding and billing guidance before a claim is submitted, assistance with monitoring claims, clearly communicated results, and payment details.

Prior Authorization (PA) Assistance

If a PA is necessary, we provide access to helpful forms and assistance with payer requirements to facilitate approval.

Appeal Assistance

Individualized guidance on appeal submission and assistance with documentation and forms. We track the status of appeals and clearly communicate results and next steps.

Financial Assistance Programs

Assistance for all qualifying patients. DEXTENZA360 will help determine patient eligibility and investigate options.

 

DEXTENZA Assistance Programs

PATIENT ASSISTANCE PROGRAM (PAP)

DEXTENZA for qualified patients in financial need:

  • Provides free product for financially eligible uninsured, government insured, and commercially insured patients with no payer coverage for DEXTENZA.

COMMERCIAL COVERAGE PATIENT ASSISTANCE

Financial assistance with out-of-pocket costs for qualifying patients:

  • For eligible patients with commercial insurance, Ocular Therapeutix covers the patient’s responsibility for DEXTENZA.

ASSURANCE PROGRAM FOR SITES OF CARE

Product replacement for denied claims (due to DEXTENZA360 error):

  • If an HCP administers DEXTENZA based on a positive insurance determination through DEXTENZA360 and is subsequently unable to obtain remuneration, providers may qualify for a billable replacement unit.
  • Applies to all insurance plans (Medicare, Medicaid, Medicare Advantage, Commercial).

UNUSABLE PRODUCT REPLACEMENT FOR SITES OF CARE

Product replacement for DEXTENZA inserts rendered unusable:

  • In the event DEXTENZA is deemed unusable after purchase, the insert can be replaced via DEXTENZA360 in qualifying circumstances.
  • FOR RETURNS OF EXPIRED PRODUCT OR PRODUCT DAMAGED IN SHIPMENT, please contact your distributor for return.
 

Making support convenient for you

Click

DEXTENZA360.com for 24/7 online access to interactive tools designed to help you throughout the access and reimbursement process.

Call

800-339-8369
(800-DEXTENZA) for your dedicated Case Manager
Monday—Friday 8:00 AM—8:00 PM ET (fax: 855-518-7564).

Connect

directly with your Ocular Therapeutix Field Reimbursement Manager or DEXTENZA360 Case Manager.

DEXTENZA360 provides comprehensive support for obtaining benefits verification and determining the appropriate codes preferred by the payer. Medicare Part B with a supplement is typically predictable regarding coverage and payment. For Medicare Advantage (Part C) or commercial patients, we recommend contacting your Ocular Therapeutix Field Reimbursement Manager or DEXTENZA360 beforehand.

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Full Prescribing Information
INDICATION

DEXTENZA is a corticosteroid indicated for the treatment of ocular inflammation and pain following ophthalmic surgery.

IMPORTANT SAFETY INFORMATION

Contraindications
DEXTENZA is contraindicated in patients with active corneal, conjunctival or canalicular infections, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella; mycobacterial infections; fungal diseases of the eye, and dacryocystitis.

Warnings and Precautions
Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision. Steroids should be used with caution in the presence of glaucoma. Intraocular pressure should be monitored during treatment.

Corticosteroids may suppress the host response and thus increase the hazard for secondary ocular infections. In acute purulent conditions, steroids may mask infection and enhance existing infection.

Use of ocular steroids may prolong the course and may exacerbate the severity of many viral infections of the eye (including herpes simplex).

Fungus invasion must be considered in any persistent corneal ulceration where a steroid has been used or is in use. Fungal culture should be taken when appropriate.

Use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation.

Adverse Reactions
The most common ocular adverse reactions that occurred in patients treated with DEXTENZA were: anterior chamber inflammation including iritis and iridocyclitis (10%); intraocular pressure increased (6%); visual acuity reduced (2%); cystoid macular edema (1%); corneal edema (1%); eye pain (1%) and conjunctival hyperemia (1%).

The most common non-ocular adverse reaction that occurred in patients treated with DEXTENZA was headache (1%).

Please see Full Prescribing Information.