Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Matri-Stem Reimbursement

For Healthcare Professionals Only

Provided by: ACell, Inc.

6640 Eli Whitney Drive
Suite 200
Columbia, MD 21046

TEL: 800-826-2926, opt. 7


FAX: 410-715-4511
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

MatriStem Prior Authorization & Insurance Verification Form: Contact program

 

Brand Name Medications Covered

 
  • MatriStem MicroMatrix tissue matrix; extracellular
 

Generic Name

 
  • matrix; lyophilized extracellular tissue matrix; extracellular
 

Eligibility Requirements   

Insurance Status Not specified
Those with Part D Eligible? No
Income Not Required
Diagnosis/Medical Criteria Not applicable
US Residency Required? Not specified
   

Application

Obtaining Doctor/Doctor's office must call
Receiving There is no application
Returning Not applicable
Doctor's Action Doctor starts the process by submitting an insurance verification request online or via fax
Applicant's Action Inform Doctor that he/she is in need
Decision Communicated Not applicable
Decision Timeframe Not applicable
   

Medication

Amount/Supply Not applicable
Sent To Not applicable
Delivery Time Not applicable
Refill Process Not applicable
Limit Not applicable
Re-application Not applicable
   

Additional Information

Resources for healthcare professionals only--reimbursement program only.


Updated July 28, 2017