CONNECT to Care
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Dompé CONNECT to Care
Access support and more from Prescription to Delivery
Providing practices and patients with assistance every step of the way
Benefits verification
Prior authorizations
Patient financial assistance
Pharmacist consultation
Delivery coordination
& confirmation
General questions
Since approval in 2018, more than 2000 total ophthalmologists and optometrists have prescribed OXERVATE®1
Patient Enrollment
How to start a patient on OXERVATE®
A
Submit a Patient Enrollment Form
Remember: Patient Authorization section of enrollment form must be completed.
A completed enrollment form serves as the OXERVATE® prescription and enrolls the patient into Dompé CONNECT to Care.
B
e-Prescribe and obtain patient consent
e-Prescribe to only 1 pharmacy:
CoAssist Pharmacy
NCPDP: 5733604 Phone: 1-855-382-2533
OR
Accredo Specialty Pharmacy
NCPDP: 4436920 Phone: 1-877-831-8112
Remember: Submit a Patient Authorization Form to provide patient consent.
Questions? Contact Dompé CONNECT to Care
With Dompé copay support, patients with commercial insurance may pay as little as $0 out-of-pocket for an 8-week course of therapy