You can submit documents and forms for your claims or reimbursement in several ways, including electronic claim via billing software (claims only), mail, fax, or uploading documents online. Note: Your privacy is important to us. Your personal information is used for internal purposes only and will never be shared. Review our privacy policy.
Upload your documents online
Patients can upload:
- Direct Member Reimbursement Form (DMR)
- Explanation of Benefits (EOB) or Pharmacy Label (EOB or Pharmacy Label must contain the patient’s responsibility or copay amount)
- Register Receipt – Proof of Payment
Healthcare professionals can upload:
- Completed CMS-1500, UB-92, or UB-04 form
- Corresponding itemized Explanation of Benefits (EOB) or Medicare Remittance Advice (RA) showing insurance payment
Note: PAN cannot process incomplete claims and will return such claims with a request for additional information. The processing time for completing claims is 10 business days.
Other ways to submit documents
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