If patient was insured, but claim was denied
When an insurance claim is denied for your patient who is receiving a Lilly oncology product, PatientOne can handle the entire claim appeal process.
WHAT TO DO |
HOW WE CAN HELP |
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1If a patient's claim is eligible,* obtain an application form. |
We will send you a form when you call 1-866-4PatOne. You can also download the form from this site. | |
2Fax completed application and all supporting materials.† |
We will complete all aspects of the appeals process with the insurer. | |
3The treating physician will receive a written response from PatientOne. |
If appeal is successful, we will follow up to ensure your office is paid. If unsuccessful after 2 levels of appeal have been concluded by PatientOne, we will check patient's financial eligibility for our PatientOne Program. If eligible, we will send replacement vials to your office.‡ |
Benefits Investigation
We provide a complete benefits investigation at no cost to patients. Simply call us at 1-866-4PatOne or download and fill out the Lilly PatientOne Enrollment form.
Payor Policies and Assistance Programs (by State)
For additional assistance, you can find more information about payor policies and other assistance programs in each state on the Payor Policies page on this site.
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*To be eligible for appeals assistance, the insured patient's claim for a Lilly oncology product must have been denied and still be within timely appeals-filing guidelines of the payer.
†For supporting materials, please include: 1) Insurance claim, 2) Explanation of Benefits form explaining the denial, 3) Treating physician's patient history/physical/diagnosis, 4) Statement of medical necessity from treating physician, 5) Signed Appointment of Representative form.
‡For patients who are eligible for reimbursement: If claim appeal is eventually successful after replacement vials are sent, the practice will be billed for the vials received.
