Resources and Services to Help Meet Patient Access Needs

BENLYSTA Gateway is a program that helps patients and healthcare professionals understand access, distribution, and reimbursement for BENLYSTA.
1-877-4-BENLYSTA (1-877-423-6597) Monday to Friday, 8 AM to 8 PM, ET
Select option 1 for BENLYSTA Gateway
BENLYSTA Gateway
The Gateway is here to:
- Help your patients understand their insurance coverage for BENLYSTA
- Enroll your patients in the Co-pay Program* or PAP if they are eligible
Services include:
- Benefits verification and prior authorization research
- Prior authorization follow-up and appeal support
- Co-pay Program
- Specialty pharmacy (SP) triage
- Patient Assistance Program (PAP)
- Claims and billing support
* For commercially insured patients, see terms and conditions for additional information.

BENLYSTA Cares is an optional program that offers your patients disease-specific education, patient support services, and other communication to support them on their treatment journey.
1-877-4-BENLYSTA (1-877-423-6597) Monday to Friday, 8 AM to 8 PM ET
* Nurses from BENLYSTA Cares do not give medical advice and will direct patients to their healthcare provider for any disease-, treatment-, or referral-related questions. Nurses from BENLYSTA Cares are available by phone Monday to Friday, 8 AM to 8 PM ET. If calling after hours, patients may leave a message and a nurse will return their call within 30 minutes.
Additional In-Office Resources
Ordering BENLYSTA
BENLYSTA is available through a variety of options.
BENEFITS INVESTIGATION AND PRIOR AUTHORIZATION (PA) RESEARCH AND SUPPORT
BENLYSTA Gateway can complete a patient-specific benefits investigation with the patient's payer† and provide PA research and support.
GSK CO-PAY PROGRAM ELIGIBILITY
BENLYSTA Gateway can evaluate eligibility for the BENLYSTA Co-pay Program.‡ Approved patients may pay as little as $0 for BENLYSTA. Up to program maximum of $15,000.
‡ The BENLYSTA Gateway Co-pay Program helps eligible approved patients with their out-of-pocket costs for BENLYSTA up to $15,000 for 12 months. Medicare-eligible patients and patients enrolled in government-funded programs are not eligible for the BENLYSTA Co-pay Program. Patients must submit a BENLYSTA Gateway Enrollment Form or complete an application online at BENLYSTAcopayprogram.com to determine eligibility. For full Program Terms & Conditions, please visit here
BILLING AND CODING SUPPORT
Physician office
BENLYSTA Gateway can provide information about relevant codes for BENLYSTA, including product codes, procedure codes, NDC numbers, and revenue codes.
Hospital outpatient department
As with coding for services performed in the physician’s office, coding preferences and requirements in the hospital outpatient setting are dependent on payer type and plan type. BENLYSTA Gateway can help identify coding requirements in both settings.
Appeals research support
If a patient is denied coverage for BENLYSTA, BENLYSTA Gateway is available to research instances of coverage denial and identify steps practices can take to appeal claims. BENLYSTA Gateway cannot author appeal letters on behalf of physicians. See sample letter of appeal below.
Sample forms and letters
When BENLYSTA is accessed throughout the patient treatment journey, a practice or hospital outpatient department may encounter the need for information on Centers for Medicare & Medicaid Services (CMS) Claim Form 1500, as well as appeal letters and letters of medical necessity. Details and examples of each are provided below.
Additional Resources
