HAEGARDA PRESCRIPTION FORM

To get your patients started on HAEGARDA, complete this Prescription Form and fax it to 1-866-415-2162. By completing this form, you’ll be providing your patients with the efficacy of HAEGARDA and all the additional benefits that go along with their prescriptions, including nurse visits for training and constant reimbursement care.

Call HAEGARDA ConnectSM at 1-844-HAEGARDA (1-844-423-4273) 8 AM to 8 PM ET.

IN-HOME NURSE TRAINING THROUGH HAEGARDA CONNECT

HAEGARDA Connect offers your HAE patients in-home training to educate on safe practices and help get them comfortable with preparing and injecting HAEGARDA. This training is available at no cost to the patient. LEARN MORE

PRIOR AUTHORIZATION CHECKLIST

This printable prior authorization checklist and common requirements document was created based on top payer policies but should not be considered specific to one particular plan.

REIMBURSEMENT AND CODING GUIDE

Access ICD-10-CM diagnosis, HCPCS, CPT®, and NDC billing codes for HAEGARDA.

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