HOW THE FOA PROGRAM WORKS

  • FOA counselor will work with you to facilitate completion of a Patient Enrollment Form (PEF)
  • FOA counselor will determine if patient's insurance covers treatment
  • FOA counselors will continue to provide support through prior authorization process, claims denials, and the appeals process

You can get started today by completing the Patient Enrollment Form or by calling 1-866-272-8838, Monday – Friday, 9:00 AM to 5:00 PM ET

WHAT DOES THE FOA PROGRAM OFFER?

Personal FOA Access Case Coordinator who can share information about insurance coverage

Copay support for eligible* commercially insured patients

Financial assistance referrals for eligible* patients

Rapid benefits investigation and verification

Prior authorization and process support

Prior authorization appeals support and claim information

Billing and coding resources

*Terms and conditions apply and can be found on the FOA enrollment form. Please be sure to share eligibility criteria with your patients. Bausch + Lomb does not guarantee coverage or reimbursement for the product.

BAUSCH + LOMB OFFERS A VARIETY OF RESOURCES FOR THE PATIENTS IN YOUR PRACTICE

Download billing and coding guides and order our retina treatments using the links below

INDICATION AND IMPORTANT SAFETY INFORMATION

XIPERE®

XIPERE® (triamcinolone acetonide injectable suspension) for suprachoroidal use is a corticosteroid indicated for the treatment of macular edema associated with uveitis.

XIPERE® is contraindicated in patients with active or suspected ocular or periocular infections including most viral dieses of the cornea and conjunctiva, including active epithelial simplex (dendritic keratitis), vaccinia, varicella, mycobacterial infections, and fungal diseases.

Click here for additional Important Safety Information For XIPERE®

Please click here for full XIPERE® Prescribing Information.

RETISERT®

RETISERT® (fluocinolone acetonide intravitreal implant) 0.59 mg is a corticosteroid indicated for the treatment of chronic noninfectious uveitis affecting the posterior segment of the eye.

Surgical placement of RETISERT® (fluocinolone acetonide intravitreal implant) 0.59 mg is contraindicated in active viral, bacterial, mycobacterial or fungal infections of the eye.

Click here for additional Important Safety Information for RETISERT®

Please click here for full RETISERT® Prescribing Information.

VISUDYNE®

VISUDYNE® (verteporfin for injection) therapy is a photoenhancer indicated for the treatment of patients with predominantly classic subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration, pathologic myopia or presumed ocular histoplasmosis. There is insufficient evidence to indicate VISUDYNE for the treatment of predominantly occult subfoveal CNV.

VISUDYNE® (verteporfin for injection) is contraindicated for patients with porphyria or known hypersensitivity to any component of this preparation.

Click here for additional Important Safety Information for VISUDYNE®

Please click here for full VISUDYNE® Prescribing Information.