Pulmozyme Access Solutions offers a range of access and reimbursement resources for your patients and practice after Pulmozyme is prescribed, including help with benefits investigations (BIs), resources for prior authorizations (PAs), sample billing and coding information, resources for denials and appeals, information about distribution and referrals to potential financial assistance options.
Get help understanding insurance benefits and coverage, such as with benefits investigations and prior authorization resources
Benefits investigations
Pulmozyme Access Solutions can conduct a benefits investigation (BI) which can determine:
*If your patient’s request for a prior authorization is not granted, your Pulmozyme Access Solutions Specialist can work with you to determine your next steps.
The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and healthcare provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.
Sample coding information and resources for denials and appeals
This coding information may assist you as you complete the payer forms for Pulmozyme. These tables are provided for informational purposes only. Please visit CMS.gov or other payers’ websites to obtain additional guidance on their processes related to billing and coding.
Download sample coding and the important safety information for Pulmozyme below.
Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and special billing requirements. Genentech does not make any representation or guarantee concerning reimbursement or coverage for any service or item.
If your patient’s health insurance plan has issued a denial, your Pulmozyme Access Solutions Specialist can provide resources as you prepare an appeal submission, as per your patient’s plan requirements.
If a plan issues a denial:
A sample appeal letter and additional considerations are available on the Practice Forms and Documents page.
Appeals cannot be completed or submitted by Pulmozyme Access Solutions on your behalf.
Submit Pulmozyme Access Solutions forms and check the status of your service requests online using My Patient Solutions
My Patient Solutions is an online tool to help you enroll patients in Pulmozyme Access Solutions and manage your service requests, all through one portal. It allows you the flexibility to work with Pulmozyme Access Solutions when it’s convenient for you.
With My Patient Solutions, you can:
How to register
Account registration can be completed by one person for the entire practice and for multiple practice locations. For help with registration or if you have questions, call Pulmozyme Access Solutions at 866-422-2377 (6AM-5PM PST, Monday through Friday).
Pulmozyme Access Solutions works with specialty pharmacies (SPs) to help patients receive their prescribed Genentech medicines.
In addition to distributing medicines, an SP may provide the following services:
You can work with your preferred SP or contact Pulmozyme Access Solutions to learn which SP the patient’s health insurance plan mandates or prefers.
Genentech does not influence or advocate the use of any one specialty distributor or specialty pharmacy. We make no representation or guarantee of service or coverage of any item. For any product-specific distribution questions call Pulmozyme Access Solutions at 866-422-2377 (6AM–5PM PST, Monday through Friday).
Pulmozyme (dornase alfa) [package insert]. South San Francisco, CA: Genentech, Inc; 2024.
Pulmozyme (dornase alfa) [package insert]. South San Francisco, CA: Genentech, Inc; 2024.
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Pulmozyme Instructions for Use. South San Francisco, CA: Genentech, Inc; 2024.
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