Many infusion sites have established their own communication protocols and/or instructions when accepting patients for therapy with REMICADE®. Infusion sites commonly request the following information, typically via fax or mail:
General Patient Information
Patient demographics and photocopy of insurance card
Patient diagnosis and history (if any) of previous therapy with REMICADE®
Pre-medication instructions, as necessary
Infusion reaction instructions
Patient clinical information: History and Physical (H&P)
Date and results of last TB test (or request for infusion site to perform new TB test)
Instructions for Therapy with REMICADE®
Rx for REMICADE®, including dosage (mg/kg) and appropriate number of 100mg vials to be infused
Infusion interval
Communication Preferences
Format: how would you like to receive feedback about your patient’s infusion experience? (for example: mail, fax, phone
call, etc.)
Frequency: how frequently would you like to receive this feedback?
Other: are there patient questionnaires/assessments you would like us to administer? (for example: IBDQ, HAQ, satisfaction survey, etc.)
Insurance Information
Determine responsibility for verification of benefits