Here are some of the commonly asked questions we receive from healthcare providers about the claims submission process.
» Billing ID Number, which contains numerals only, and can be found on the patient’s PAN welcome letter.
» Group Number, which can be found on the patient’s PAN welcome letter.
» Claim form (HCFA-1500, UB-04 or UB-92). Click here for a list of required fields on the claim form.
Note: Providers must submit the actual claim form. Copies of electronic forms will not be accepted.
» Supporting documentation
» Primary and secondary explanation of benefits, as applicable.
» W-9 (required annually with your practice’s first claim of the year).
Note: PAN’s Direct Member Reimbursement (DMR) forms are for member reimbursement only.
You can submit claims electronically through your billing system, or by fax or mail using the contact information below:
» Electronic: Payer ID 38225 (Payer ID is tied to NGS American)
» Fax: (844) 726-4728
» Mail: PAN Foundation
PO Box 2310
Mt. Clemens, MI 48046
Electronic claims must be submitted one at a time. To fax or mail more than one claim, please complete and include the PAN Medical Claim Fax Cover Sheet between every individual medical claim.
The standard processing time for complete claims is 10 to 14 business days. Claims are processed on a first-come, first-served basis. Please keep in mind that any missing information may lead to delays in claim processing time.
There are three payment options for providers: QuicRemit virtual credit cards, ACH transfers or paper checks. QuicRemit virtual credit cards are the default payment method. All direct member reimbursement claims are paid by check only.
There are two ways to check claims and payment status:
» View payment details through the PAN Provider Portal at providerportal.panfoundation.org
» Call PAN at 866-316-7263, Monday through Friday, 9 a.m. to 5 p.m. ET.
For faster payment, we recommend submitting claims electronically. Electronic claim submission ensures that claims are complete, and reduces the turnaround time by two business days.
Want to sign up for electronic claim submission? Contact your billing vendor for more information.
If your claim was denied, it will be returned to you along with a letter indicating the reason for denial. You can also check the provider remittance for the claim denial reason. If additional information is required or you would like the claim to be reconsidered, please resubmit the claim with both the original documents and updated information.
If you are resubmitting a claim with all the required information, be sure to write “Corrected Claim” at the top of the claim form so the PAN team knows that new information has been added.
If you have questions about the PAN Provider Portal, please contact PAN at 866-316-7263, Monday through Friday, from 9 a.m. to 5 p.m. ET.
Do you have a PAN story? We would love to hear from you! Please click here to share your PAN story today.
PAN’s Webinar Library features webinars on a variety of topics specific to providers. To view the full list of PAN webinars, please go to the PAN Webinar Library page, or click here.
This PAN provider brochure provides essential information to help our providers assist their patients quickly and efficiently.
We continue to collect stories from PAN providers about their experiences working with us.
At PAN, we always strive to offer our providers new and relevant information. That's why we produce a provider-specific quartlerly newsletter.
Click here to see if your patient qualifies for PAN’s Medicare-only funds.
This webinar focuses on updates to the PAN Provider and Pharmacy Portals and gives a preview of the new features.
In this Introduction to PAN Webinar, you will learn how to navigate the PAN website, find disease funds and covered medications, what materials and information are needed to use the web portals and more.
In this Patient Enrollment Webinar, you will learn how to access and use the Provider and Pharmacy Portals to enroll a patient.
In this Portal Management Webinar, you will learn how to access and navigate the recently enhanced Provider and Pharmacy Portals.
The Patient Assistance Safety Net:
How Many Need Help? How Many Are Helped?
The Patient Access Network (PAN) Foundation and The American Journal of Managed Care® (AJMC®) seek papers that quantify the need for patient assistance and the size of the safety net, and answer the following questions.
Need for Patient Assistance
For the underinsured population, how many people need financial assistance to pay for the out-of-pocket (OOP) costs associated with their prescription medications? What is the dollar amount of assistance that is needed?
How large is the current safety net for people who need financial assistance to pay for the OOP costs associated with their prescription medications? How many and what kinds of safety net programs are available? What diseases and medications do they cover? How much assistance do they provide? How many people are unable to get the help they need? Are there factors that limit the reach of safety net programs?
PAN Challenge entrants shall:
» Address either the need for patient assistance or size of the safety net, or both.
» Describe the research conducted to analyze and quantify the need for patient assistance and/or the size and characteristics of the safety net.
» Identify the population and specific medical conditions researched, if appropriate.
» Identify proposed recommendations to address the need for patient assistance and gaps in the safety net.
The PAN Challenge is open to individuals and teams of individuals who are sponsored by: a) a university or college; b) a department/school within a university/college; c) a health system; d) a nonprofit organization; or e) a for-profit entity. Collaborations are encouraged between organizations; however, one will be designated as the Sponsoring Organization.
How to Enter
» One Sponsor Organization will be selected as the Winner of the PAN Challenge and will receive $10,000.
» One Sponsor Organization will be selected as the Runner-Up of the PAN Challenge and will receive $5,000.
» Up to three Sponsor Organizations will be selected as Honorable Mentions of the PAN Challenge and will each receive $1,500.
» The Winner and Runner-Up will each be given an opportunity to present at the Cost-Sharing Roundtable, to be hosted by the PAN Foundation and AJMC®, tentatively scheduled for February 2018.
» Papers of the Winner and Runner-Up Sponsor Organizations will be published in a future print and online supplemental edition of AJMC®. Sponsor Organizations of Honorable Mentions may receive recognition and be included in the Supplement.
For more information about the 2017 Call for Papers:
2016 PAN Challenge:
2015 PAN Challenge:
MJ Kelly, Director of Billing and Reimbursement, CVS/Caremark Specialty Pharmacy
“Our goal is to get patients on therapy as quickly as possible. PAN’s portal allows us to do just that. Patients are approved quickly and move forward with their therapy rather than going without medication or making other major financial sacrifices. Not only does PAN provide a wide range of therapies and generous amount of funding per patient, they also have a passion for what they do. It’s quite moving to see what PAN is able to provide for our patients.”
Angela Magaha, Patient Advocate Manager, Park Pharmacy and Tennessee Oncology
“PAN offers the portal access, which gives us the opportunity to work with the patient, and it allows patients to stay ahead in getting their co-payment assistance. It also allows our team to process information efficiently - we’re able to help more patients because we’re able to process a patient on the portal within 15 minutes of just entering the information.”
Stacey McCullough, PharmD, Director of Pharmacy Services, Park Pharmacy and Tennessee Oncology
“Working with the PAN Foundation, an organization that has streamlined the process and made getting the required information as easy and as quick as possible, is very beneficial. It helps us out from a business standpoint to be able to provide this service, in all aspects of care. To have a partner that recognizes the end goal is very valuable.”
Anne Hollingsworth, Funding Supervisor, Diplomat Pharmacy
“A differentiator for PAN is its efficiency. The turnaround time is great. When patients can access grants quickly, it makes it easy for us and takes a lot of the stress off patients. Everyone wins.”
Brad Zimmerman, MSW, APSW, OSW, Oncology Social Worker, Aurora Advanced Healthcare in Milwaukee
“I am proud of the fact that with the help of organizations like PAN, our practice is able to identify assistance for about nine out of 10 of our patients who are struggling to pay for treatment. We work hard to make sure our patients have the opportunity to get the first line of therapy that they are prescribed. Patients are so appreciative and thankful when life-saving treatments are accessible because of PAN’s assistance.”
John Helfrich, Director of Pharmacy Operations, Oncology Rx Care Advantage Pharmacy
“Among underinsured patients, people understand a treatment might mean dipping into savings or everyday expenses to pay out-of-pocket costs. Once they weigh expensive options, patients often choose a less costly route. That is where PAN comes in. PAN allows doctors to offer the best treatment, focusing on treating the patient in the way that is most suitable. The PAN portal offers us the opportunity to input and process information faster, saving numerous days of worry for patients. PAN offers providers value-added information, too. Through our connection with PAN, we receive email updates about new funding. Our mission is to serve the patients and walk beside them through their illnesses. PAN helps us do that...it's a leap forward in assistance with patients.”
In a recent survey, more than 80 percent of PAN providers said healthcare costs were impacting their medication and treatment decisions more now than one year ago.
Patients should never have to face major financial trade-offs, like selling their homes, in order to follow their treatment plans. That’s why providers play a vital role in linking PAN and underinsured patients who need help to afford the co-payments, coinsurance and deductibles associated with their medications.
More than 95 percent of PAN providers say PAN support has a positive impact on patients’ ability to comply with treatment. The caring and highly trained staff at PAN carefully guide providers and advocates through the application and claims process. Several key benefits in working with PAN include: