2. Mission
To help underinsured people with life-threatening, chronic and rare diseases get the
medications and treatment they need by paying for their out-of-pocket costs and
advocating for improved access and affordability.
Vision
We envision a nation in which everyone can get the health care they need.
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Who We Are
3. To view the webinar, double click below.
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View the Webinar
4. PAN Foundation 4
How Can a Patient Submit Claims to PAN?
• Pharmacy – payment goes to the pharmacy
• Physician – payment goes to the physician
• Patient – payment goes to the patient
5. Step 1: Patient Collects and Completes Documents
Proof of Expenditure (POE) form available at www.panfoundation.org
• To be completed only when payment should be sent to the patient
• Forms will be returned if used by physicians or pharmacists
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6. Step 1: Patient Collects and Completes Documents (cont.)
Proof of purchase
• Medication received from the pharmacy: prescription label, payment receipt
• Medication received at the physician’s office: Explanation of Benefits
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7. Mail or fax claims to:
Patient Access Network Foundation
PO Box 2310,
Mt. Clemens, MI 48046
Fax: 1-844-726-4728
Completed claims are processed within 10 business days.
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Step 2: Patient Sends in Claim Documents
8. Payment is sent by check to the address indicated on the POE form.
Questions? Call PAN at 1-866-316-7263
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Step 3: Patient Receives Payment
9. Contact Information
Providers or Pharmacies: Ayesha Azam, Director of Provider Relations
202-347-4451 | aazam@panfoundation.org
PAN Foundation is open Monday – Friday, 9 a.m. to 5 p.m. ET
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10. Contact Information
Providers or Pharmacies: Ayesha Azam, Director of Provider Relations
202-347-4451 | aazam@panfoundation.org
PAN Foundation is open Monday – Friday, 9 a.m. to 5 p.m. ET
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