Claims Process Checklist

AAA PatientCONNECT can research payer-specific coding requirements in performing patient insurance benefit verification for LUTATHERA® (lutetium Lu 177 dotatate) patient financial assistance.

Providers should confirm the appropriate coverage, coding, and reimbursement with the applicable payer or claims processor before submitting claims for an item or service. Providers must ensure that all claims submitted to payers are accurate, complete, and adequately supported by documentation in the medical record.

Payers differ on guidelines and criteria required for billing an office visit on the same day as other physician services. It is important to verify appropriate coding with a patient’s health insurance plan before submitting the claim form for reimbursement. Additional information required by the payer may include:

  • LUTATHERA Prescribing Information
  • FDA approval letter for LUTATHERA
  • Patient medical history/medical notes
  • Letter of medical necessity
  • Invoice for LUTATHERA
  • Payer specific NOC billing requirements
  • National Drug Code (NDC) for LUTATHERA (Medicaid and/or commercial payers)
Please be informed that we have adopted new enrollment forms, starting from August 1, 2018. If you need assistance with completing the forms, please call AAA PatientCONNECT at 1-844-NETS-AAA.
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