COMMITED TO PATIENT ACCESS

Ordering and Reimbursement

How to order ExEm® Foam

Option 1: Purchase through Cardinal Third Party Logistics
  • If you have an existing Cardinal Third Party Logistics account:

    • Call 1.844.963.EXEM (3936). Cardinal Third Party Logistics will work with ExEm® Foam to approve your account and to confirm initial training has been completed so you may proceed with placing an order.
  • If you do not have an existing Cardinal Third Party Logistics account:

    1. Download and complete the Cardinal 3PL Application and Terms and Conditions
    2. Submit the application to gmb-sps-exemfoam@cordlogistics.com
    3. Cardinal Third Party Logistics will contact you to confirm your application submission. Cardinal Third Party Logistics will work with ExEm® Foam to approve your account and to confirm initial training has been completed so you may proceed with placing an order.
Option 2: Prescribe ExEm® Foam to your patients through a preferred pharmacy
  • Your patient’s prescription for ExEm® Foam can be fulfilled through any pharmacy and shipped directly to your office or picked up by your patient. You may send your prescription through your EMR system or contact us for an Enrollment form at 1.888.963.EXEM(3936) and fax to the pharmacy.

    • For your convenience we have contracted pharmacies throughout the U.S. for immediate availability.
    • If you have a pharmacy you would like to work with that is not on our preferred list, please send an email to contracting@exemfoam.com to request a contract with the pharmacy.
  • The pharmacy will be responsible for collecting any applicable co-pays or out-of-pocket costs, if needed.

  • The pharmacy will ship ExEm® Foam directly to your office or contact your patient when its ready for pick up.

  • Your office will need to separately bill clinical services and practice expenses related to the HyFoSy procedure.

In-Person Demo Training and Demo Products

We are here to support your team and ensure you have the necessary training and educational resources to get started with ExEm® Foam. To schedule an in-person demo and to order demo products, please fill out the following form and a representative will be in touch with you: www.exemfoam.com/contact

ExEm Foam provides training and education on the safe and effective use of our products.

Guide to Coding & Reimbursement for Clinics

Let us guide you through the reimbursement process.

Contact the ExEm® Foam Reimbursement Advisor Team for guidance and assistance with industry compliant reimbursement procedures. We are readily available to assist with reimbursement questions and to provide appropriate support of appeals, pre-authorization and pre-certifications. ExEm® Foam strives to provide support and education for appropriate patient access, and ensure safe and effective use.

For support, call 1.888.963.EXEM (3936) or send an email to reimbursement@exemfoam.com.

Reimbursement Programs to Assist You and Your Patients

We are committed to supporting the reproductive and infertility communities by assisting physicians and patients with access to ExEm® Foam for HyFoSy tubal patency testing. ExEm® Foam Inc. offers the following programs intended to assist you and your patients:

Clinic Rebate Program*

To balance reimbursement claims billed to medical benefits, ExEm® Foam is offering a Clinic Rebate Program dependent on reimbursement from the payor. Agreement to the pilot program terms and conditions will be required to participate. Contact our Reimbursement Advisor Team to learn more at 1.888.963.EXEM (3936) or send an email to reimbursement@exemfoam.com.

* Excludes any and all Federal Health Care Programs. May not be available in all states.

Patient Copay Assistance Program**

ExEm® Foam is offering a patient rebate program to assist your patients with affordable access if they may not have insurance coverage, if they are underinsured or if they have high out-of-pocket costs. You or your patients may visit the link below or call 1.844.205.3607 to learn more about the program and eligibility.

** Excludes any and all Federal Health Care Programs.

Learn More and Apply

No Insurance or denied claims

If your patient doesn’t have insurance, or her insurance doesn’t cover ExEm® Foam, she may pay for ExEm® Foam out-of-pocket through the pharmacy and may apply for the ExEm® Foam Patient Copay Assistance Program mentioned above.

Reimbursement Avisor Team Support for Clinics and Physicians

To contact our Reimbursement Advisor Team, call 1.888.963.EXEM (3936) or send an email to reimbursement@exemfoam.com.