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RESOURCES

  • OMIDRIAssure® Flashcard

    Overview of the OMIDRIAssure program

  • We Pay the Difference Submission Form

    To enroll patients in the We Pay the Difference patient reimbursement program for commercially insured patients

  • OMIDRIAssure Patient Certification Form

    To determine patient eligibility for the Equal Access patient assistance program

  • Ordering Information Sheet

    Wholesaler/distributor and billing information for OMIDRIA

  • Reimbursement Guide

    An important office guide to coding and billing for OMIDRIA, including sample claim forms

  • Procedure Guide

    Storage, preparation, and administration information for OMIDRIA

  • ASC Payment Schedule

    Click here and select the latest quarterly ASC payment rate addenda for current ASC payment information

  • HOPD Payment Schedule

    Click here and select the Addendum A and Addendum B Updates option. Select the latest quarterly Addendum B payment schedule for the current HOPD payment information

  • Letter of Medical Necessity Sample

    Template letter used to communicate with payers. Can be customized to establish the medical reason OMIDRIA was used with a patient

  • Letter of Appeal Sample

    Template letter used to communicate with payers. Can be customized to appeal a payer’s decision not to reimburse the use of OMIDRIA with a patient

    Omeros Corporation does not warrant the accuracy, completeness, or current status of information provided on third-party websites.

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