The CONTOURSM NEXT Reimbursement Support Program

The CONTOURSM NEXT Reimbursement Support Program can assist you and your patients with:
  • General Reimbursement Questions (e.g.: Savings Eligibility)
  • Benefit Verification (e.g.: Insurance Formulary Status)
  • Prior Authorization & Insurance Appeals (e.g.: When CONTOUR® NEXT Test Strips are not covered)
Need reimbursement support for CONTOUR® NEXT Test Strips?

GET STARTED TODAY

Call today at 1.866.296.1436 (M – F 8 AM – 7 PM ET) or email us at: Reimbursement@ContourNextHelp.com and a reimbursement specialist will contact you within a few days.
 
Want to save time? Click HERE to fill out the CONTOURSM NEXT Authorization Form for the CONTOURSM NEXT Reimbursement Support Program. Send your completed form to Reimbursement@ContourNextHelp.com
 
 

PRIOR AUTHORIZATION FORMS

While CONTOUR® NEXT products are covered by many insurance plans, some of your patients may have a managed care plan which does not cover CONTOUR® NEXT Test Strips.
 
In such cases, you and your patients may decide to appeal to your patient's managed care plan on their behalf, and request a prior authorization for coverage.
 
Please use the below forms and complete the required information, including the reason for medical necessity for a Prior Authorization:
 
Click HERE to access the Prior Authorization Form for the CONTOUR®NEXT LINK 2.4 Meter for use with the MiniMed® 630G system with SmartGuard™ technology
 
Click HERE to access the Prior Authorization Form for the CONTOUR® NEXT LINK Meter for use with Medtronic MiniMed® 530G with SmartGuard™ technology
 
Click HERE to access the Prior Authorization Form for the CONTOUR® NEXT LINK Meter for use with MiniMed® Paradigm® REAL-Time Revel™ insulin pumps
 
For your convenience, please note these forms can be filled out before printing.
 
 

Ascensia Diabetes Care is committed to making testing affordable for your patients and with CONTOUR® NEXT your patients are covered:

 

CoPay: with the CONTOUR® Choice card, eligible privately insured patients can save up to $105 every month on their CONTOUR® NEXT Test Strip copay. *

 

Cash: CONTOUR® NEXT Test strips are available at the lowest shelf-price of all leading brands and with the CONTOUR® Choice card, patients can save an additional $25 every month.

 

Medicare: CONTOUR® NEXT Test Strips are always covered by Medicare Part B. ††

 
 
* Valid for up to 12 months of refills through 12/31/2017. Offer not valid on 25 count test strips. ELIGIBLE PRIVATELY INSURED PATIENTS pay the first $15 of co-pay on Rx of 300 test strips or less and receive up to $35 in savings off of remaining copay. For quantities over 300, patient contributions and card benefits increase accordingly – up to $45 and $105 respectively. CASH PATIENTS can receive savings up to $25 per month. For questions call 1-855-226-3931. RESTRICTIONS: Offer not valid for prescriptions reimbursed under Medicaid, Medicare drug benefit plan, Tricare or other federal or state health programs (such as medical assistance programs). If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. It is illegal to (or offer to), sell, purchase, or trade this offer. Valid only in the US. Void where prohibited. Program managed by PSKW, LLC on behalf of Ascensia Diabetes Care. The parties reserve the right to rescind, revoke or amend this offer without notice at any time.

BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THE RESTRICTIONS.

PATIENT ALSO CERTIFIES THAT S/HE WILL COMPLY WITH ANY TERMS OF HIS/HER HEALTH INSURANCE CONTRACT REQUIRING THAT PAYOR BE NOTIFIED OF THE EXISTENCE AND/OR VALUE OF THIS OFFER.

† Average retail price per 50ct. IRI data, 52-week period ending 03/20/16
†† Medicare requires you to pay 20% of the Medicare-approved amount after your yearly Part B deductible for diabetes monitors, test strips, lancets, and lancing devices.
CONTOURSM NEXT
Authorization Form
Email completed form to: Reimbursement@ContourNextHelp.com
Prior Authorization Form
CONTOUR®NEXT LINK 2.4 meter for use with the MiniMed® 630G system with SmartGuard™ technology
Prior Authorization Form
CONTOUR® NEXT LINK Meter for use with Medtronic MiniMed® 530G with SmartGuard™ technology
Prior Authorization Form
CONTOUR® NEXT LINK Meter for use with MiniMed® Paradigm® REAL-Time Revel™ insulin pumps