BPPS is here to work with you, your doctor's office, and your health insurance company.
Telephone lines are staffed between 6 AM and 5 PM (PT) Monday through Friday. Callers can leave a message during after hours and all messages are returned within one business day during regular business hours. BPPS can also be reached via fax at 1-888-863-3361. Patients and healthcare professionals can also e-mail BPPS any time at
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to arrange for a specific follow-up time.
If your doctor and you have decided that you should try KUVAN, you qualify. Because KUVAN is the first prescription medication for the treatment of PKU, getting insurance coverage on your own may be slow or challenging, even with the best insurance plans. BPPS was created to ease the insurance approval process for you, and increase the speed at which it is done.
No. BPPS is an integral part of your treatment with KUVAN, regardless of insurance or income status. All patients who have been prescribed KUVAN will need to go through the BPPS process before receiving the medication.
Every patient prescribed KUVAN will have to go through BPPS as it is a service to help facilitate
obtaining KUVAN.
BPPS can refer patients to the National Organization for Rare Disorders (NORD), an organization that specializes in this type of assistance for patients with rare diseases. NORD has set up a fund that provides premium and co-payment assistance for eligible patients receiving prescription medication for PKU. For an overview of NORD, click
here. For more FAQs about NORD, click
here.
BPPS will research alternative insurance coverage options for you. With the new health care reform changes, patients now have more options to obtain coverage. As a last resort, BPPS can refer patients to the KUVAN Patient Assistance Program (K-PAP), a program that provides KUVAN at no charge for qualified patients without insurance coverage. For an overview of K-PAP, click
here. For more FAQs about K-PAP, click
here.
Some insurance companies may need to approve a patient's treatment with KUVAN before treatment is started. This approval is called "prior authorization." Typically, the insurance company will require the patient’s doctor to provide a Letter of Medical Necessity and/or medical information to the patient's insurance company that explains why the doctor wants the patient to start this treatment.
If the insurance company denies coverage of KUVAN, denies the doctor's request for prior authorization, or simply will not cover the cost of the medication, BPPS will help prepare and file an appeal with the insurance company. The appeal will outline why the patient should be receiving KUVAN and how it may benefit the patient. An appeal is used to persuade the insurance company to allow coverage for and access to KUVAN, and to ensure that the insurance company has all the information required. Coverage decisions will vary among insurance companies. If the appeal fails, BPPS will continue to work with the patient to research other options for access to KUVAN.
With the new health care reform changes, lifetime maximums should no longer be in effect. BPPS will help you investigate how your insurance company is updating their coverage policy to adhere to the new laws. For additional information, patients can call toll-free: 1-877-MY-KUVAN (1-877-695-8826) or they can e-mail
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for information.
BPPS is available to help KUVAN patients evaluate different insurance options and encourages patients to contact BPPS with questions related to open enrollment, when a child loses coverage from his/her parents' insurance, or other potential changes in health plan coverage. The new health care reform changes may affect your existing coverage. BPPS will help you investigate how your insurance company is updating their coverage policy to adhere to the new laws. For additional information, patients can call toll-free 1-877-MY-KUVAN (1-877-695-8826) or they can e-mail
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for information.
Yes. Each BPPS case manager has a secure, dedicated e-mail address for patients and healthcare professionals to use. BPPS is committed to responding to personal e-mails within one business day of receipt. We encourage individuals with concerns needing more immediate attention to call the KUVAN Hotline at 1-877-MY-KUVAN (1-877-695-8826).
Please return the phone call or the completed paperwork as soon as possible. There are several steps involved in starting KUVAN therapy, and questions may come up along the way. BPPS stays in touch with patients and healthcare professionals frequently throughout the process to provide status reports, answer questions, and obtain information needed to move to the next step.
Once BPPS receives the signed Patient Authorization Form, BPPS calls the patient within one business day to provide an introduction to the BPPS case manager and program. After the initial telephone contact, BPPS contacts the patient to discuss the results of benefit investigations for KUVAN, identify plans for addressing additional health plan requirements for coverage, or discuss patient concerns about financial issues associated with therapy. After KUVAN therapy is initiated, BPPS provides updates about the patient’s case as needed.
Once BPPS receives the signed Statement of Medical Necessity/Prescription Form, an acknowledgment fax is sent to the referring healthcare professional the same day it is received. After the referral notification, BPPS sends weekly faxes that outline where the patient is in the reimbursement process, and later list the name and contact number of the specialty pharmacy that is shipping KUVAN to the patient. Patients approved for initial therapy are asked to contact their healthcare professional to discuss the start of treatment. BPPS contacts referring healthcare professionals if any additional assistance is needed (examples: updated medical records, confirmation of prescriptions, or assistance with answering health plan questions).
The goal is to have healthcare professionals and patients associated with a clinic work with the same case manager. All calls to BPPS are routed through a single toll-free number to make sure that they get to the proper person. E-mails go directly to case managers.
