Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with EntyvioConnect Copay Program (administered by ConnectiveRx) before sending sensitive documents. FaxFlow is not affiliated with this organization.

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EntyvioConnect Copay Program (administered by ConnectiveRx) fax number

(844) 595-6272

Copay Program Help Desk

Used for: Enrollment and submission of copay assistance and reimbursement requests for EntyvioConnect; fax documents to 1-844-595-6272 (Pay to Invoice and Copay Claim forms).

Fax destination details

Department
Copay Program Help Desk
Purpose
Enrollment and submission of copay assistance and reimbursement requests for EntyvioConnect; fax documents to 1-844-595-6272 (Pay to Invoice and Copay Claim forms).
Form
Pay to Invoice Request Form — EntyvioConnect Pay to Invoice Request Form
Voice phone
1-800-352-2236

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fax the completed Pay to Invoice Request Form along with required documents (CMS 1500/UB04, Explanation of Benefits, supplier invoice with Entyvio price, denial/appeal docs; include patient Copay Member ID when possible) to 1-844-595-6272.

Official form instructions are published as a downloadable file on the organization's website.

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