Start here to conduct a benefits review, initiate assistance with prior authorizations and appeals, and request financial support program enrollment for eligible patients. Once the enrollment form has been submitted and a benefits review has been conducted, you will receive your patient’s summary of healthcare benefits.
Select the appropriate medication below to begin online enrollment. Once you complete your portion of the enrollment form, your patient will receive an email prompting them to complete and sign their portion of the form. Enrollment is not complete until the patient form has been completed and signed. Need help getting started? Download our Online Enrollment User Guide.
If you prefer to manually complete the enrollment process, please download the appropriate enrollment form below based on the product your patient has been prescribed and fax the completed form to the number listed on the form.
Note, a completed form requires signatures from both physician AND patient. Completed forms should be faxed to the number provided on the form.
If your office prefers to complete enrollment manually via fax but your patient is not present, patients can sign their Patient Authorization and Agreement form electronically. Visit the patient e-signature portal.
Download a helpful benefits and coverage form for patients.
Watch this video to learn about the enrollment process for BMS Access Support.
Enroll, track, and manage your patient cases in real time for BMS medications.
