Why Is It Important to Fill Out New Client and CAP Forms?
Horizons in Hemophilia, August 2009
By Jenny Truesdale, Business Department Assistant
Clients who are new to Hemophilia of Georgia’s pharmacy are asked to compete and return several important forms. You may wonder what these are all about and why they need to be filled out.
Pharmacy operations are closely regulated through the state and federal government and HoG works diligently to comply with all of these regulations. The pharmacy is required to have a signed copy of the Client Choice and Delivery Waiver forms on file for each pharmacy client. Your signature on the Client Choice form indicates that you understand that you have a choice of pharmacy providers and that you are not required to order from HoG. Signing the Delivery Waiver form gives HoG authorization to ship factor and other medications to you through Fed Ex or UPS or another carrier.
The HoG pharmacy also needs your signature on an Assignment of Benefits form. This form authorizes your insurance provider or Medicare or Medicaid to pay Hemophilia of Georgia for the products you receive from the pharmacy. It also allows HoG to provide necessary medical information to the insurance provider. A new Assignment of Benefits form must be completed every time a client’s insurance changes, so some clients are asked to complete this form several times.
These three forms are sent to new pharmacy clients with their first order and clients are asked to complete and return them right away. We must have these forms on file in order to continue shipping your medications to you.
The other very important form is the Client Assistance Program (CAP) form. This program provides funds to cover insurance co-payments and/or high deductibles, based on financial need. The CAP form should be completed and returned promptly so that HoG social workers can review the information to see if the client qualifies for the program.
So if you see these forms in your order or if we have mailed them to you, please take the time to complete and return them to us. You can fax them to 770-518-3310 or you can return them in the postage paid envelope included in the mailing with the forms.