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Additional materials you might need to enroll patients

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Supplementary materials, all in one handy place

Here are the materials you may need to get your patients started on their way to enrolling in NUPLAZIDconnect. They don’t replace the treatment form, but may be required for supplementary information.

Select what you need.


Prior Authorization

Your patient may need authorization to get insurance coverage for NUPLAZID® (pimavanserin).

Formulary Lookup

See if your patient’s
insurance will cover
NUPLAZID® (pimavanserin).

Letter of Appeal Template

Your patient may need a letter of appeal if a previous authorization request has been denied.

Letter of Medical Necessity Template

You may need to document a patient’s medical necessity for treatment to get insurance coverage.

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Questions? Connect with a NUPLAZIDconnect representative.

1-844-737-2223
Monday through Friday
8:30 AM-8:30 PM EST

For healthcare professionals