www.merckcscn.com - Nexplanon Direct Service Request Form

Tips and Tricks

by Acc Admin 61 Views 0

www.merckcscn.com - Nexplanon Direct Service Request Form

Tips and Tricks

by Acc Admin 61 Views 0

The Direct Service Request Form provides a good opportunity to find out more information about the insurance coverage for Nexplanon for the patient through Merck Customer Support Center for Nexplanon (CSCN). The request form can be filled for benefit investigation for Nexplanon and prescription order. You can choose any service or both of them.

How to complete the Direct Service Request Form

To accomplish the entire process is a very easy and simple process and will not take much time to complete. Here is a quick guideline for completing the Direct Service Request Form to help you out.


  • Select the Specialty Pharmacy.
  • Fill out the form by entering prescriber information, patient information, patient insurance information, prescription information and all other required fields.
  • Complete and print the form.
  • Make the printed form sign by both the physician and patient.
  • Fax it to the number provided on the Merck CSCN portal page or the Direct Service Request Form.

Important Notes

  • The benefit investigation will be completed within 2 business days after receiving the Direct Service Request Form.
  • Don’t forget to check the “Services Requested” box and select a Specialty Pharmacy.
  • Ensure that prescriber must sign twice on the form- first on the “Dispenser as Written” line and then on the “Prescriber Signature” line.
  • For patient insurance information, you can write the required details or the best way you can is to attach the copies of both medical and prescription benefit cards.
  • You can download the important instructions provided on the CSCN portal page.

About Merck

Merck & Company, Inc., enlisted on the New York Stock Exchange under the symbol MRK, is an American pharmaceutical company providing their services over 140 countries across the world. It is the seventh largest pharmaceutical company by market capitalization and revenue. Initially, the company was started as a subsidiary of German multinational pharmaceutical, chemical and life Sciences company, Merck in 1891. In 1917, it was established as an independent company. Merck & Company is headquartered in Kenilworth, New Jersey, US. Outside USA and Canada, the company known is as Merck Sharp & Dohme or MSD. This global healthcare company has approx. 69000 employees throughout the world as of 2017.

Contact Details

If you have any question or issue regarding the completing or submitting the form you can contact the customer support center at:

Phone- (844) 639-4321

Fax- (844)232-2618

For corporate inquiries

Merck Headquarter

2000 Galloping Hill RD

Kenilworth, NJ 07033

Phone- 908-740-4000 (8.30 am to 5.30 pm)


References

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