START SMART WITH HAEGARDA
To help get patients started on HAEGARDA faster:
Print and fill out the forms below prior to your patient’s visit, in case additional information from their insurance company is requested.
Fax completed HAEGARDA Prescription Referral Form to HAEGARDA ConnectSM at 1-866-415-2162.
* If you need to file an appeal, whether standard or urgent, contact HAEGARDA ConnectSM at 1-844-HAEGARDA (1-844-423-4273) to be connected with one of CSL Behring’s Field Reimbursement Managers.
HAEGARDA ConnectSM will confirm receipt and may contact you for additional documents requested by insurer.