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Frequently Asked Questions

 
  1. Where should I send my enrollment application?
  2. How long does the approval process take and how will I know whether I’ve been approved?
  3. What if I am not approved and still have high copayments?
  4. Once I am approved for a grant, how long is my eligibility period?
  5. How much assistance will I receive?
  6. How do I submit a claim?
  7. Who receives payment from the PAN?
  8. How can I check my grant balance?
  9. How do I use my PAN ID card?
  10. What should I do if I lose my PAN ID card?
  11. Can I obtain reimbursement for medication expenses I received before I began assistance with PAN?
  12. What if I change my contact information, provider, or medications?
  13. My enrollment period is ending soon. Is my assistance renewable?
 1. Where should I send my enrollment application?
  • You may mail or fax your enrollment application to PAN:
  • Mail: PAN Foundation, PO Box 221858 Charlotte, NC 28222-1858
  • Fax: 1-866-316-7261
 2. How long does the approval process take and how will I know whether I’ve been approved?
  • If you complete the application through our online patient, provider or pharmacy portals, you will instantly receive your eligibility determination. In addition, our online portals allow you to immediately print enrollment information, your PAN ID number, and the awarded grant balance.
  • If you apply by phone (1-866-316-7263), your eligibility determination will be provided once we have obtained all of your demographic and financial information. The representative will provide enrollment dates, your PAN ID number, and awarded grant balance to phone applicants.
  • In either case, you may begin using your benefits immediately by providing this enrollment information to your provider or pharmacy.
  • Note: You will receive a formal approval letter and benefit card in the mail within a week. Your provider will also receive an approval letter within the same time period.
 3. What if I am not approved and still have high copayments?
  • To determine financial eligibility, PAN applies a standard income deduction that varies based on insurance type. Individuals with income levels that still do not allow them to qualify for PAN assistance will be provided with a referral to available third-party programs.
 4. Once I am approved for a grant, how long is my eligibility period?
  • Assistance starts on your approval date and continues for 12 months. Your exact eligibility dates will be included in your PAN approval letter, and can be accessed any time using PAN’s automated telephone system, at 1-866-316-7263.
  • Note: During your initial eligibility period, eligible expenses incurred up to 90 days prior to your approval date may also be submitted to PAN for reimbursement.
 5. How much assistance will I receive?
  • Grant amounts vary for each disease-specific program. Your approval letter will contain this information.
 6. How do I submit a claim?
  • Patients, healthcare providers and pharmacies may submit requests for reimbursement to PAN for medications covered by their disease fund. Charges incurred within 90 days prior to the eligibility date will be considered for payment during the first year of PAN coverage. All eligible expenses must be submitted within 120 days of the eligibility end date.
  • » Patients
    • Primary insurance must be billed prior to the claim being submitted to PAN for reimbursement. In addition, the primary insurance must consider the charge to be an eligible expense.
      • » Complete and submit a Proof of Expenditure Form
      • » Attach a copy of the explanation of benefits, if applicable
      • » For services rendered at a pharmacy, attach a copy of the prescription label/pharmacy invoice indicating the date of service, drug name, and patient’s co-payment amount, along with proof of payment
      • Mail or fax claims to:
      • Mail: Patient Access Network Foundation, PO Box 2310, Mt. Clemens, MI 48046
      • Fax: 1-844-726-4728
  • » Physicians/Health Care Providers
    • Primary insurance must be billed prior to the claim being submitted to PAN for reimbursement. In addition, the primary insurance must consider the charge to be an eligible expense. For detailed instructions, click here to view and print the PAN Foundation Provider Billing Guide.
      •  Claims can be filed through any of the three methods below:
      • » Submit electronically using payer ID 38225
      • » Mail to: PAN Foundation, PO Box 2310, Mt. Clemens, MI 48046 (CMS-1500 or UB-40 must be used with this method of submission)
      • » Fax to: 1-844-726-4728 (CMS-1500 or UB-40 must be used with this method of submission)
      • Note: A copy of the explanation of benefits from the primary payer must be attached when you submit your claim. Pharmacies
    • Primary insurance must be billed prior to the claim being submitted to PAN for reimbursement. In addition, the primary insurance must consider the charge to be an eligible expense. For detailed instructions, click here to view and print the PAN Foundation Pharmacy Billing Guide.
    • PAN grantees will present for payment his or her benefit card. If the patient does not have his or her benefit card, pharmacies may contact PAN toll free at: 1-866-316-7263, Monday through Friday, 9 a.m. to 5 p.m. EST, for electronic billing assistance.
      • Claims can be filed through two methods listed below:
      • » Submit electronically using RX BIN 006012, PCN: MEDDPDM. You must use patient Billing ID and RX Group – this can be found on the patient’s PAN ID card.
      • » Mail to: PAN Foundation, PO Box 221858 Charlotte, NC 28222-1858
      • (CMS-1500 or UB-40 must be used with this method of submission)
      • Note: A copy of remittance advice/invoice from the primary payer must be attached when you submit your claim.
 7. Who receives payment from the PAN?
  • Payment from PAN can be made to a pharmacy or healthcare provider who supplies the treatment, as well as directly to a patient if the patient paid out-of-pocket for eligible expenses.
 8. How can I check my grant balance?
  • You can check your grant balance by calling 1-866-316-7263 and speaking to a PAN customer service representative. PAN customer service representatives are available, Monday through Friday, 9 a.m. to 5 p.m. EST.
 9. How do I use my PAN ID card?
  • Present your PAN ID card at your doctor’s office or at a participating pharmacy at the time services are rendered.
 10. What should I do if I lose my PAN ID card?
  • If you misplaced or do not have your benefit card, the pharmacy can call 1-866-316-7263, extension 72244 for electronic billing assistance, which is available Monday through Friday, 9 a.m. to 5 p.m. EST.
 11. Can I obtain reimbursement for medication expenses I received before I began assistance with PAN?
  • During your initial enrollment period, PAN will consider for reimbursement medication expenses incurred up to 90 days prior to your approval date.
 12. What if I change my contact information, provider, or medications?
  • A change in your contact information, provider or medications will not change your enrollment. If your information has changed, call us at 1-866-316-7263 to update your records.
 13. My enrollment period is ending soon. Is my assistance renewable?
  • If you meet the program-specific eligibility criteria, you are eligible for a renewal grant at the end of the enrollment period, if funds are available. PAN will automatically send you a renewal application at the end of your enrollment period if the specific disease program is accepting renewal patients.