Acthar Gel
Patients
Payors

Williams, Robert

Member ID: Not Available
Benefit Verification
In Progress
Prior Authorization
Pending
Patient Information
Patient Name
Williams, Robert
Member ID
Not Available
Date of Birth
07/03/2022
Phone
Not Available
Address
Not Available
Date Opened
03/18/2024
Prescription Information
Prescribing Physician
Dr. Michael Chen
Medication
Acthar Gel
Strength
60mg/0.6mL
Frequency
1 / Day / 14 Days
Actions
Insurance Information
Insurance Provider
Aetna
Medical Condition
Infantile Spasms
Member ID
Not Available
Timeline
  • Benefit Investigation In Progress
    Verifying coverage for Acthar Gel with Aetna
    2/15/2026
  • Patient Record Created
    Initial patient record created for Williams, Robert
    03/18/2024
  • Patient Chart Received
    Patient chart and medical records uploaded to system
    03/18/2024
  • Referral Form Received
    Acthar Gel referral form received from physician
    03/18/2024
  • Eligibility task created
    Task created to verify patient eligibility
    03/14/2024 10:30am