Need to ask PAN for a reimbursement or submit a claim?
Learn the steps for sending a bill to PAN.
Providers and pharmacists should scroll to their specific billing guide. If you are a grant recipient or caregiver, please follow the steps below.
For grant recipients and caregivers
If your pharmacy or provider does not send the bill to PAN, you should:
- Pay the out-of-pocket cost for your medication or treatment
- Download the direct member reimbursement form below
- Send the form to PAN through the patient portal, mail, or by fax
After we have your completed form, you should get a check within 10 business days. You can always call us to check the status of your reimbursement request.
Direct reimbursement form
If you have a PAN grant, you can ask for reimbursement for approved expenses using the direct reimbursement form.
Don’t fill out this form if your provider or pharmacist has sent or will send a claim for you
This billing guide is intended to support provider office personnel with PAN billing. The PAN Foundation contracts with Trustmark Health Benefits, formerly known as CoreSource, to process medical claims.
This billing guide is intended to support pharmacy personnel with PAN billing. The PAN Foundation contracts with SS&C Health, formerly known as DST Pharmacy Solutions, to process pharmacy claims.