What is the Grant Use Policy?
PAN’s Grant Use Policy encourages grant recipients to use their grants as intended to help cover the out-of-pocket costs for critical medications. You, your patient or your patient’s pharmacist must request and receive payment for a claim from PAN within 120 days of your patient’s enrollment date. Throughout your patient’s eligibility period, PAN must receive another claim within 120 days of the previous claim.
If grant recipients do not follow the Grant Use Policy, their grants will be canceled, and the released funds will be used to provide grants to other patients who need assistance. If you have questions, call PAN at 1-866-316-7263.
Please note, PAN grant recipients must be currently in treatment, scheduled to begin treatment in the next 120 days or have had treatment in the past 90 days. If you have extenuating circumstances, please let us know.
Is this policy new?
PAN has always reviewed grant activity to ensure we are helping as many patients as possible. The addition of this policy makes it easier for PAN to track grant usage, and make sure grant dollars can help the maximum number of patients.
Does my patient know about this policy?
Beginning May 7, 2018, patients will be informed of PAN’s Grant Use Policy both at the time of their enrollment and in their grant approval letter.
How can I make sure that my patients keep their grants?
To ensure patients keep their PAN grants, please submit claims to PAN promptly, and work with your patients to ensure that they submit claims promptly.
You or your patient must request and receive payment for a claim from PAN within 120 days of your patient’s enrollment date. Throughout your patient’s eligibility period, PAN must receive another claim within 120 days of the previous claim, or your patient’s grant will be canceled.
How can I make sure my claims are submitted in a timely fashion?
To ensure your claims are submitted to PAN in a timely fashion, make sure to submit the claim immediately after your patient picks up or receives their medication or treatment. If you are billing PAN on your patient’s behalf, please remind your patient to submit the claim promptly to his or her insurance company and then submit the claim to PAN.
I thought my patient’s grant was for a year. Why do I need to submit something within the first 120 days?
Your patient’s grant is for a year, but all PAN grant recipients must request and receive payment for a claim from PAN within the first 120 days to ensure that they are actively using their grant, as outlined in the Grant Use Policy. If a grant recipient does not follow the Grant Use Policy, their grant will be canceled, and that funding will be awarded to another patient who needs assistance. If your patient has extenuating circumstances that will prevent them from requesting and receiving payment for a claim from PAN within the first 120 days, please call PAN at 1-866-316-7263.
What happens to my patient’s grant if he doesn’t request and receive payment for a claim from PAN within 120 days?
If you or your patient do not request and receive payment for a claim from PAN within 120 days of their enrollment date, your patient’s grant will be canceled. If your patient needs assistance at a later date, he or she is welcome to reapply for assistance, pending fund availability.
Is this a rolling 120-day period, or three separate four-month intervals?
The Grant Use Policy operates on a rolling timeframe of 120 days. Once you or your patient requests and receives payment for a claim from PAN within his or her first 120 days, the timeframe resets, and he or she must request and receive another payment from PAN within 120 days of the previous claim.
Will this be retroactive and apply to existing grants, or is the Grant Use Policy only for new grants?
The Grant Use Policy affects new grants, but PAN reviews all grant activity to help patients track and maintain their grants and ensure that grants are being used appropriately.
What if my patient’s treatment is only once or twice a year?
PAN grant recipients must be currently in treatment, scheduled to begin treatment in the next 120 days or have had treatment in the past 90 days. We recognize that some of your patients’ treatment may not fit within the 120-day timeframes of the Grant Use Policy. If you have a patient whose treatment is only once or twice a year, and he or she receives a letter from PAN indicating that they must use their grant soon, please call PAN at 1-866-316-7263. We will take this under consideration.
Does the 120-day period reset on the date my patient receives treatment?
No, the 120-day period resets on the date the claim is paid by PAN. You can find out when your patient’s claim was paid by logging into your PAN Provider Portal account, or by calling PAN at 1-866-316-7263.
I have confirmation that a claim was faxed, but my patient’s grant was canceled. Can I get my patient’s grant back?
If your patient’s grant was canceled and they have an extenuating circumstance, please call us. We will take this under consideration.
My doctor submitted my claim, and it is pending. What happens if I miss the deadline?
If your insurance company is still reviewing your claim and you are concerned about missing the 120-day deadline, please call PAN and let us know before the 120th day. We will take this under consideration.
