Prescriptions and Reimbursement Support
The Acthar Support and Access Program (ASAP) Will Do the Work Call 1-888-435-2284 or Fax 1-877-937-2284
the Acthar Referral/ Reimbursement Support is available Monday-Friday, 8:00 AM to 8:00 PM Eastern Time. The confidential fax line is available 24 hours a day, All prescription orders and requests for reimbursement support |
Click below to download and print the Acthar Referral/Prescription Form:
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The Acthar Support & Access Program (ASAP) Will:
- Contact the patient’s insurance company
- Investigate benefits and facilitate any prior authorizations if necessary
- Route to the appropriate Specialty Pharmacy for fulfillment
- Ship Acthar Gel and the necessary supplies next day for overnight delivery to the patient’s home or alternate location under the appropriate temperature-controlled conditions.
When calling the Acthar Support and Access line, please have the following information ready:
- Patient’s name, address, and date of birth
- Patients’ diagnosis and dosage prescribed
- Insurance plan name, ID number, and group number
- Physician’s name, address, and phone number
Telephone and fax inquiries received after the close of normal business hours will be responded to the next business day.