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ORENCIA Co-pay Program (Bristol Myers Squibb) fax number

(800) 856-9036

Co-pay Program

Used for: Submit Co-pay Program Check Request for reimbursement of eligible out-of-pocket costs

Fax destination details

Department
Co-pay Program
Purpose
Submit Co-pay Program Check Request for reimbursement of eligible out-of-pocket costs
Form
Check Request Form — ORENCIA Co-pay Program Check Request Form
Address
PO Box 2355 Morristown, NJ 07962
Voice phone
800-803-3407

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  • 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 or mail this form with a detailed Explanation of Benefits (EOB) to the provided fax number to request payment from the ORENCIA Co-pay Program; include patient and provider details and service date.

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