Provider Frequently Asked Questions

General

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The Assistance Fund (TAF) is an independent charitable patient assistance organization that helps patients and families facing high medical out-of-pocket costs by providing financial assistance for their copayments, coinsurance, deductibles, and other health-related expenses.

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TAF provides financial assistance for more than 90 diseases. To view the complete list of TAF disease programs, visit our Covered Diseases page.

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The Assistance Fund (TAF) Headquarters:

8427 Southpark Circle
Suite 100
Orlando, FL 32819

Enrolling Patients

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You can get current member status and billing information for patients using the following methods:

TAF Member Card Lookup Tool

24-7 Self-service telephony menu at (855) 845-3663. Go to the provider menu and enter the patient’s Member Number and date of birth. You will hear whether the Member Number is active, inactive, or pending. If the patient is active, you will hear their up-to-date coverage amount.

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If a patient is flagged for a financial or diagnosis audit, TAF will send correspondence to the patient alerting them that supporting documentation is required to validate their eligibility and continued program participation. If patients do not provide the requested information within 30 days, TAF will terminate their assistance.

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No. Once a patient is enrolled in a TAF disease program, their coverage lasts the entire calendar year. We carefully review and allocate our funds to ensure patients are covered through a given year. Once patients are approved and enrolled in a TAF disease program, there is no cap on the amount of assistance a patient receives in a calendar year.

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Providers, case managers, caregivers, and Patient Advocates can apply on behalf of a patient. Applications can be received online or by telephone, electronic document upload, fax, or mail. To apply on behalf of a patient, the following information is required from the patient:

Name
Address
Phone number
Date of birth
Confirmation of U.S. citizenship or residency
Patient insurance and prescription information
Patient income information (household size and household income)

If the patient meets initial program eligibility, conditional approval may be granted. Conditional approval gives patients 30 days of immediate assistance from disease programs that are accepting new patients. To receive assistance beyond the 30-day period, patients must submit a completed application, including their signature and agreement to the Program Terms and Conditions within the conditional period.

If the disease program is not accepting new patients, patients may sign up for the waitlist.

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TAF accepts referrals from reimbursement services providers. Reimbursement services providers can refer a patient by visiting enroll.tafcares.org and selecting the appropriate disease program. There, they can click “Apply,” and select “I’m a reimbursement services provider.”

Processing/Billing Information

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Pharmacy:

You can submit claims electronically through your billing system, or by fax or mail, using the contact information below. You will need the following information to submit a claim:

Member Number: Reference patient search within the Provider Portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
Group Number: Reference patient search within the Provider Portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
Rx BIN: 610600
PCN: AS
Processing Code: 08
AlphaScrip
5080 N 40th St., Suite 339
Phoenix, AZ 85018
Phone – (866) 897-2833
Fax – (602) 840-9508

Site of Care/Infusion Center:

You can submit claims electronically through your billing system, or by fax or mail using the contact information below. You will need the following information to submit a claim:

Member Number: Reference patient search within the Provider Portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
Group Number: Reference patient search within the Provider Portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
Payor ID: 86753

 

Florida Health Administrators
Payor ID 86753
P.O. Box 21426
Eagan, MN 55121
Phone – (866) 236-2673
Fax – (954) 901-2711

 

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Please mail refunds to the following address:

The Assistance Fund
Attn: Finance
8427 Southpark Circle
Suite 100
Orlando, FL 32819

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For healthcare providers who are administering a prescription medication at their site of care, payments are facilitated through a claims administrator. You may submit claims electronically, by fax, or by mail:

Florida Health Administrators (FHA) TPA
Payer ID: 86753
PO Box 21426
Eagan, MN 55121
Phone Number: (866) 236-2673
Website: File a Claim

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Pharmacy:

You can submit claims electronically through your billing system, or by fax or mail, using the contact information below. You will need the following information to submit a claim:

Member Number: Reference patient search within the Provider Portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
Group Number: Reference patient search within the Provider Portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
Rx BIN: 610600
PCN: AS
Processing Code: 08
AlphaScrip
5080 N 40th St., Suite 339
Phoenix, AZ 85018
Phone – (866) 897-2833
Fax – (602) 840-9508

If your claim was denied, you should have received a rejection code. Please follow the instructions on the rejection code, call us at (855) 845-3663, or call AlphaScrip’s Help Desk at (877) 274-3244. Ensure you are submitting the correct information (e.g., the correct BIN, Member ID Number, etc.).

If you are not currently in AlphaScrip’s network and you would like to join, please call (877) 274-3244.

Additional information for pharmacies

In order to determine a patient’s remaining copay responsibility, as well as to obtain a patient’s member benefits with our program, please contact a TAF Patient Advocate at (855) 845-3663.

For pharmacies unable to support electronic billing information or a claims adjudication system, payments can also be facilitated through a Visa E-Card. To establish an E-Card or set up a payment for your patient, please contact a Patient Advocate at (855) 845-3663.

To verify a patient’s enrollment status, please call TAF at (855) 845-3663 and select Option 2. You will need the patient’s Member Number and date of birth.

Download our Provider Resource Guide.

Provider Portal

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To reset your Provider Portal password, follow the following four steps:

Step 1: From the main Portal login page, select “Forgot your password?”

Step 2: Enter your email address into the “Username” field and “Send Password Reset Email”

Step 3: Check your email for the link to reset your password. Clicking on the link will open a “Change Your Password” page.

Step 4: Follow the instructions to “Change Your Password”

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To request a Claim Override on a claim, select New Case > Case Type = Claim Override > Claim Sub-type = Override Request > Question: I need to submit an override on a claim. Once you submit a request, you may upload supporting documentation by going to My Cases, selecting the appropriate case number, and selecting the tab labeled “Upload Documents.”

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No, you cannot view your coworkers’ patients in the Provider Portal. Each user within your organization must individually register for Provider Portal access under the associated NPI.

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Yes. During reenrollment, providers will be able to see when a patient applies for reenrollment and the reenrollment decision for the following year. Providers can visit the patient account page within the Provider Portal to view patient’s enrollment information.

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No, you cannot add a patient to the Provider Portal if they are not enrolled in a TAF disease program. The Provider Portal links providers to their patients through submitted claims; once a claim is submitted by a provider, the patient and their information will appear under the “My Patients” tab.

Waitlist

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You can refer your patient to join a TAF disease program waitlist. TAF will then contact the patient to complete their online enrollment application to secure waitlist placement. Disease programs accepting waitlist applications are marked with “WAITLIST” on the TAF Program Listing webpage. Once you select the disease program, click “Join Waitlist.” You will be prompted to identify yourself as a Healthcare Provider, Pharmacy Provider, or Reimbursement Services Provider. After you make your selection, you must complete the waitlist referral form. Please inform your patient that you referred them to join a TAF disease program waitlist and that they should expect to be contacted by TAF with instructions on how to complete their waitlist enrollment.

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In order to complete the referral process, you will need to provide patient contact and demographic information.

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An email address is not required to join a disease program’s waitlist; however, patients must select a method of communication (voice call, text, or email) when completing their waitlist application. TAF will use the patient’s preferred communication method to contact them about required actions or changes in their waitlist status. It is critical that the patient provide accurate contact information, or the patient may not receive TAF’s communications. TAF highly recommends selecting text or email, as those methods allow patients to easily complete the enrollment process using links. If the patient selects voice call as their preferred communication method, they will need to fill out a paper application to complete the waitlist enrollment process.

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Once you submit the referral, TAF will contact the patient to complete their online (or paper) enrollment application to secure their waitlist placement.

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No; enrollment in a TAF program requires patient acceptance of the Program Terms and Conditions as well as HIPAA acknowledgment. You can refer the patient to TAF’s disease program waitlist and TAF will then contact your patient to complete their enrollment application. Please inform your patient that you referred them to join a TAF disease program waitlist and that they should expect to be contacted by TAF with instructions on how to complete their waitlist enrollment.

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No; enrollment in a TAF program requires patient acceptance of the Program Terms and Conditions as well as HIPAA acknowledgment. You can refer the patient to TAF’s disease program waitlist and TAF will then contact your patient to complete their enrollment application. Please inform your patient that you referred them to join a TAF disease program waitlist and that they should expect to be contacted by TAF with instructions on how to complete their waitlist enrollment.

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If you need to make changes to the patient contact information or communication preferences, please contact a TAF Patient Advocate at (855) 845-3663.

Provider Grant FAQ

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TAF applies grant-based limits in a small number of its disease programs where there is high variability in patient out-of-pocket costs. Grant-based limits allow TAF to help as many patients as possible access the treatment they need.

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TAF’s grant-based programs provide copay, coinsurance, and deductible assistance to patients for the calendar year or up to the specified grant amount, whichever comes first. The grant amount is determined by the disease program in which the patient is enrolled. The grant may be used for copays, coinsurance, and deductibles for all FDA-approved treatment for the disease named in the disease program.

Enrolled patients may also receive assistance with other eligible out-of-pocket costs, such as health insurance premiums and incidental medical expenses (as outlined in the program coverage details), which is not counted toward their specified grant amount. There is no cap on the amount of assistance a patient receives in a calendar year for these eligible expenses.

To learn more about which out-of-pocket medical expenses are covered in a patient’s disease program, visit enroll.tafcares.org and select their disease program.

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If the value of a patient’s grant runs out and the status of the disease program for which they are enrolled is “open,” their enrollment will be automatically renewed and they will receive another grant. If the status of the program is “waitlist,” they may apply for the disease program waitlist. To secure a place on the waitlist, patients must complete an enrollment application and meet program qualifications. When funding is available, TAF will send them an invitation using their selected method of communication.

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No. TAF copay grant programs only provide assistance for copays, coinsurance, and deductibles for FDA-approved treatment for the disease named in the disease program.

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In addition to copay, coinsurance, and deductible assistance on FDA-approved treatment for the disease named in the disease program, TAF financial assistance grant programs provide assistance for other eligible out-of-pocket costs, such as health insurance premiums and incidental medical expenses. Reimbursements for health insurance premiums and incidental medical expenses are not counted toward the specified grant amount. There is no cap on the amount of assistance a patient receives in a calendar year for these eligible expenses.

To learn more about which out-of-pocket medical expenses are available through your patient’s disease program, visit enroll.tafcares.org and select the disease program.

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No, patients in TAF grant programs are ineligible for Reenrollment. If the value of a patient’s grant runs out and the status of the disease program for which they are enrolled is “open,” they may apply for an additional grant. If the program status of their program is “waitlist,” they may apply for the disease program waitlist.

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Yes. When a patient has exhausted their grant amount and their enrollment is automatically renewed, TAF will send them a new member card with a new group number. Patients must give their provider their new member card.

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No. If a patient receives a grant in last quarter of the year, they will receive two member cards: one for the current year and an additional one for the upcoming year. They must give their provider their new member card.

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Grant amounts are determined by the disease program in which a patient is enrolled. If a patient is conditionally approved or they enroll in the last quarter of the year, their grant amount may be adjusted.

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Patients who are conditionally approved for a grant-based disease program are eligible for 30 days of assistance or up to the specified grant amount, whichever comes first. The grant amount for a conditionally approved patient is equivalent to one month of the total grant amount. Once a patient has completed their application and is fully approved, they are eligible for assistance for the calendar year in which they enrolled or up to the full grant amount, whichever comes first.

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TAF conducts annual assessments to determine which disease programs offer grants and which offer unlimited copay assistance. The terms and conditions of a patient’s disease program will not change during the year they are enrolled. If the terms and conditions of their disease program are slated to change in the upcoming year, TAF will notify them in advance.