Download Axumin® (fluciclovine F 18) injection Resources

Reimbursement tip sheet

Download a checklist with useful tips for prior-authorization, pre-determination, and appeals.

Payer worksheet

Blue Earth has developed a worksheet to help you keep track of the Axumin coverage policies and billing requirements of your local payers

Patient benefit verification form

To enroll a patient for Axumin reimbursement support services, healthcare professionals must download, complete, and submit the Axumin Patient Benefit Verification Form.

Scheduling sheet

For use by referring physicians when scheduling a patient for Axumin imaging. Provides the relevant information required by the imaging facility. Download the Scheduling Sheet and/or the companion Scheduling Tip Sheet.

Sample claim forms

Download examples of Axumin claim information entered into CMS-1500 and UB04 forms to use as a reference when submitting claims.

Patient brochure

Download the Axumin patient brochure, “What to Expect.”