Dysport – Ipsen

Ipsencares.com or call 1-866-435-5677

Coverage for 4 treatments or 1 year from enrollment date, whichever comes first

o Program resets every Jan 1st

Backdates up to 6 months from enrollment date, multiple EOBs can be submitted at once

Maximum reimbursement of $5,000 per 12-month rolling period

o No cap per injection

Patient enrolls, ipsen entered as secondary or tertiary insurance, check is mailed to provider

Patient also has option to pay at TOS, and receive reimbursement check in mail directly to them after submitting EOB to ipsen

Backdates 6 months