Seagen Secure® works with your patients to get them enrolled* and started on their prescribed Tivdak® (tisotumab vedotin-tftv) for injection therapy. Once a patient is enrolled, Seagen Secure® will help patients understand their insurance coverage and financial assistance options.
In it right
from the start
*Seagen does not guarantee that enrollment will result in patient assistance, coverage, and/or reimbursement.
*Seagen does not guarantee that enrollment will result in patient assistance, coverage, and/or reimbursement.
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How to enroll your patients for Tivdak® (tisotumab vedotin-tftv) for injection access support
OR
FAX 855-557-2480
Download, complete, and fax the following:
Healthcare Provider Request Form Patient Authorization Form
PHONE 855-473-2873
Contact Seagen Secure® to enroll over the phone, Monday-Friday, 8 am-8 pm ET.
CLICK TO CALL NOWOncology Access Advocate
Once enrolled, your patient will be assigned a dedicated Oncology Access Advocate who can assist with any coverage or financial issues:
Benefits investigation
The Oncology Access Advocate will help determine coverage, evaluate prior authorization requirements or other restrictions, and determine the patient’s financial responsibility. The Oncology Access Advocate may also help them understand their benefits for eye exams associated with their Tivdak prescription, as well as provide 3 eye care professionals closest to their home that are covered by their insurance
Appeal assistance
If a patient’s insurer denies a prior authorization request and you want to appeal, the Oncology Access Advocate can identify the appropriate steps
Commercial out-of-pocket assistance program†
The Oncology Access Advocate may be able to offer your patient enrollment in this program, designed to lower out-of-pocket costs for each prescription
Uninsured and underinsured patient assistance†
The Oncology Access Advocate can approve eligible patients for Tivdak therapy, free of charge
† Patients must meet eligibility requirements. Terms and conditions apply.
Enrollment Steps
- Complete this form with your patient
- In-office
- Remotely
- Submit to Seagen Secure®
- An Oncology Access Advocate will reach out within 1-2 business days
Make sure you have the following information to complete the enrollment form:
- Your practice information, including:
- Address and contact details
- Tax ID Number
- National Provider Identifier (NPI)
- Details regarding your patient's clinical diagnosis and treatment
- Your patient's personal, financial, and contact details
- Your patient's insurance card and/or insurance information
Resources and Forms
Seagen Secure® provides materials to help your patients get started on therapy
All materials listed are readily available to download:
Enrollment Forms
Reimbursement and Other Resources
Appeals Request Guide
Coding and Billing Guide
Sample Codes for Eye Care Administration
ICD-10 Guide
How to Locate a Medicaid Eye Care Provider
Prior Authorization Guide
Tivdak® (tisotumab vedotin-tftv) Full U.S. Prescribing information, including BOXED WARNING for Ocular Toxicity
Quick Guides
Seagen Secure® Flashcard
FAQs
Online Enrollment Navigational Resource