Tools and Resources

Enrollment

Sample Letter of

Medical Necessity

Find a TOGETHER with TESARO™ Case Manager

FAQs

Enrollment

Enrollment into TOGETHER with TESARO is easy!

Once you have consent from your patient, you can enroll in 3 different ways:

Online Enrollment: Use this form if your office dispenses therapy OR does not dispense therapy but still would like to use TOGETHER with TESARO services. You will need to provide your prescription separately via fax or your e-prescribing system.

Downloadable Enrollment Form: This form can be downloaded, saved, and faxed to TOGETHER with TESARO. Use this form if your office dispenses therapy OR does not dispense therapy but still would like to use TOGETHER with TESARO services.

Biologics, Inc. Prescription Referral Form: If your office does not dispense therapy, you may use this form. This form can be downloaded, saved, and faxed to Biologics, Inc.

Online Enrollment

Please select the services being requested (select all that apply):

Note: Please complete and fax the Rx separately to 1-800-645-9043. A TOGETHER with TESARO™ Case Manager will contact you upon receipt of a completed application.

If you close the browser or select another link on the website, the information entered will not be retained.

Once you have consent from your patient, you can enroll them in TOGETHER with TESARO.

To enroll online or download the enrollment form, please access this website through a computer.

Sample Letter of Medical Necessity

The Sample Letter of Medical Necessity can be sent to insurance companies in the case of a medical exception or denial. This template letter is meant to assist you in your coverage requests, and requires that you fill out specific information before submitting.

To download the Sample Letter of Medical Necessity, please access this website through a computer.

Download this Sample Letter of Medical Necessity on the right to send to insurance companies in the case of a medical exception or denial. This template letter is meant to assist you in your coverage requests, and requires that you fill out specific information before submitting.

Find a TOGETHER with TESARO Case Manager

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Please enter your ZIP code in the box to the rightbelow and select Find my Case Manager to identify your TOGETHER with TESARO Case Manager.

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  • [First name, Last name]
  • Case Manager
  • Email: [firstname.lastname]@tesaroprp.com
  • Phone: 1-844-2TESARO ext [xxxx]
  • 1-844-283-7276
  • Monday through Friday (8 AM to 8 PM ET)

  • Fax: 1-800-645-9043

No Case Manager found matching your criteria. Please try again or call 1-844-2TESARO (1-844-283-7276).


FAQs

Below is a list of frequently asked questions. If you have other questions, please contact your Case Manager.

Q: What assistance does TOGETHER with TESARO provide?

A: TOGETHER with TESARO provides assistance with questions related to insurance coverage for insured patients and access to VARUBI® (rolapitant) for uninsured patients. Our solutions include:

  • Benefits Investigation
  • Prior Authorization Facilitation and Appeals Support
  • First Dose Program
  • Commercial Co-pay Assistance Program
  • Referrals to Independent Co-pay Foundations
  • Patient Assistance Program

Q: What products are supported by TOGETHER with TESARO?

A: Currently, TOGETHER with TESARO only supports VARUBI. As new products become available from TESARO, they too will become part of this program.

Q: What is VARUBI?

A: For information on VARUBI, go to www.VARUBIRx.com or contact your TESARO Area Manager.

Q: How can I obtain an enrollment form for the program?

A: Enrollment can be done online, through a downloadable pdf, or from a print form. Please click here to enroll your patient.

To enroll online or download the enrollment form, please access this website through a computer.

Q: How long will it take to process a program enrollment form?

A: Once received, we attempt to process an enrollment form and respond to the request within 1-2 business days.

Q: Who should I contact with any questions about the status of a program enrollment?

A: Your TOGETHER with TESARO Case Manager is your main point of contact for any questions you may have. TOGETHER with TESARO Case Managers are available to help. Find your Case Manager today.

Q: Are the TOGETHER with TESARO resources free?

A: Yes, the TOGETHER with TESARO resources are available at no cost to you or your patient.

Q: Will TOGETHER with TESARO help me determine if VARUBI® (rolapitant) is covered for my patient?

A: After you complete and sign the TOGETHER with TESARO Enrollment Form, a benefits investigation will be conducted and your patient's eligibility will be reported back to your office.

Q: How long will it take to complete a benefits investigation?

A: We attempt to provide complete benefits details within 1-2 business days of the original request. If we are unable to obtain specific benefits information for VARUBI within that time, we will continue to follow up with the insurance plan and provide you with periodic updates.

Q: Can TOGETHER with TESARO write an appeal letter for me?

A: No, unfortunately we’re unable to write an appeal letter on your behalf. The appeals process typically requires a medical appeals letter written by a physician. We can, however, provide a Sample Letter of Medical Necessity.

To download the Sample Letter of Medical Necessity, please access this website through a computer.

Q: Can you send the documentation for VARUBI® (rolapitant) to my patient’s insurance company?

A: No, we are not able to submit any documentation to an insurer on your or your patient’s behalf. We can, however, provide you with information regarding the appeals process, benefits, and coverage requirements and services that may help your patient start treatment while resolution is pending.

Q: How can I find out more about the Samples Program, the First Dose Program, the Patient Assistance Program, or the Commercial Co-pay Assistance Program?

A: Your TOGETHER with TESARO Case Manager is your main point of contact for any questions you may have. TOGETHER with TESARO Case Managers are available to help. Find your Case Manager today.

TOGETHER with TESARO offers tools and resources designed to help your office. This section will evolve and expand as we learn more about what you need. Keep coming back for new information, and please tell our Case Managers how you think we're doing!