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Office Resources

See below for resources that can help set your office up for success when starting patients on BIMZELX® (bimekizumab-bkzx). To request printed copies of the materials, please contact your UCB representative.

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To share one or more resources, check the box(es) next to the item(s), then select the “Email” button.

GETTING STARTED

Healthcare Acronym List
Healthcare Acronym List

Definitions of common acronyms use in the healthcare industry.

ENROLLMENT

Patient Enrollment Form (PEF)
Patient Enrollment Form (PEF)

Document for collecting patient information to get patients started on treatment.

PEF Guide
PEF Guide

Highlights key elements of the PEF to complete, plus a sample filled-out form.

Specialty Pharmacy Contact Information
Specialty Pharmacy Contact Information

Contact information for UCB’s enhanced network of Specialty Pharmacies.

Enrollment Options
Enrollment Options

Shows the ways an HCP can prescribe BIMZELX to a patient and the two ways an office can capture the patient’s authorization to use/disclose health information.

Key Contacts
Key Contacts

Lists contact information for team members who can assist professional staff and patients throughout treatment.

APPROVAL PROCESS

Patient Approval Process Map
Patient Approval Process Map

Visual guide that breaks down treatment initiation process for the patient based on prescribing method.

  • Direct-to-Hub
  • Direct-to-Bridge–Dispensing Pharmacy
  • Direct to-non-Bridge–Dispensing Pharmacy
Sample Verification of Benefits Form
Sample Verification of Benefits Form

An example of a completed form that offices can expect to receive upon submitting a prior authorization.

Prior Authorization Request & Letter of Medical Necessity Guide
Prior Authorization Request & Letter of Medical Necessity Guide

Provides guidance on how offices can appeal an initial insurance coverage denial.

Prior Authorization (PA) Process Overview
Prior Authorization (PA) Process Overview

An introductory explanation of commonly required patient information and the role of a Case Manager in the PA process.

Prior Authorization (PA) Request Guide
Prior Authorization (PA) Request Guide

A step-by-step guide to completing a PA Request Form.

Sample Prior Authorization (PA) Request Form
Sample Prior Authorization (PA) Request Form

An example PA form that shows information that is typically needed for submission.

Appeals Process
Appeals Process

Visual guide that explains the process for submitting an appeal if a prior authorization was denied.

Patient Financial Support
Patient Financial Support

Breaks down the financial support options that are available to help patients get started on treatment.

ACCESS AND AFFORDABILITY

Insurance Basics
Insurance Basics 

Definitions for common terminology found in insurance and healthcare plans that may appear in BIMZELX Navigate® documents.

Summary of Benefits and Coverage
Summary of Benefits and Coverage

A template to help your patients understand what questions to ask regarding their health insurance plan, including benefits, coverage, and costs.

Medicare Managed Care Guide
Medicare Managed Care Guide

Provides information on Medicare-managed care enrollment, eligibility requirements, and related policies.

Patient Assistance Program Form
Patient Assistance Program Form

A digital enrollment form for eligible patients seeking financial assistance for UCB medications.

PROGRAM OVERVIEW

Nurse Navigator Overview
Nurse Navigator Overview

Details the benefits and support Nurse Navigators can provide patients.

BIMZELX Navigate Program Overview
BIMZELX Navigate Program Overview

Provides information about key features of the program, including onboarding, access and affordability, and adherence support.

BIMZELX Navigate FAQ List
BIMZELX Navigate FAQ List

Answers to frequently asked questions about  BIMZELX Navigate.

BIMZELX Navigate Portal Overview
BIMZELX Navigate Portal Overview

Introduces the functionality of the portal and how professional staff can gain access.

Glossary of Terms
Glossary of Terms

Provides definitions of common terms used in the BIMZELX Navigate program as well as the insurance industry.

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BIMZELX Navigate Training Course

Learn key topics at your own pace to help you onboard patients seamlessly. Our easy-to-use virtual training course offers 7 lessons, covering material like:

  • BIMZELX basics
  • Prescribing BIMZELX
  • Treatment access options
  • Office and patient support resources
  • The BIMZELX Navigate Portal
  • The MyNavigate Portal
  • Your UCB support team

Visit Our Training Course