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Sample Letter of Medical Appeal
A letter with a customizable template for you to use if a health plan denies your patient access to SUSTOL.
Product and program information
Coding Reference Guide
Listing of Diagnostic, NDC, HCPCS, JW Modifier, CPT, and Revenue Codes for SUSTOL.
SUSTOL product-specific J-Code is J1627.
Heron Connect Reimbursement Support Reference Guide
Reference guide describing the Heron Connect Programs and Services.
Heron Commitment Program® Flashcard
Highlights the coverage denial support provided to your practice through the Heron Commitment Program.
Insurance Verification and Program Enrollment Form
One single form used to verify benefits and enroll patients in Heron Connect Programs.
Practice Copay Assistance Program Enrollment Form
A one-time form your practice must complete in order to participate in the simplified Heron Connect Copay Assistance Program registration process.
Patient Copay Assistance Program Registration Form
A form used to enroll individual patients solely into the Heron Connect Copay Assistance Program. The one-time Practice Copay Assistance Program Enrollment Form must also be completed.
Clinical materials and patient resource
Instructions for Use (IFU)
A document with information about the preparation and administration of SUSTOL®.