Provider FAQs

General

What is The Assistance Fund?

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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.

What are the diseases for which TAF provides assistance?

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TAF manages more than 70 disease programs. For the most current list of covered diseases, please visit our Covered Disease page.

What is your address?

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Orlando Headquarters:

The Assistance Fund
4700 Millenia Blvd., Suite 410
Orlando, FL 32839

Washington, D.C. Office:

The Assistance Fund
655 15th St. NW, Suite 502
Washington, DC 20005

Enrolling Patients

How can I confirm a Member’s coverage status?

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You can get current Member status and billing information 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.

How or why would a patient be terminated before the end of the calendar year?

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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 account.

Is there a cap on patient 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 keep their coverage during 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.

Would you like to apply on behalf of a patient?

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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.

Processing/Billing Information

What information do I need to submit 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 portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
Group Number: Reference patient search within portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
RX BIN: 610600
PCN: AS
Processing Code: 08

Alpha Scrip
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 portal, Member Card Lookup Tool, or by viewing the patient’s Member Card.
Group Number: Reference patient search within 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

Where should refunds be mailed?

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Please mail refunds to the following address:

The Assistance Fund
Attn: Finance
4700 Millenia Blvd., Suite 410
Orlando, FL 32837

How do I submit a claim from my site of care, infusion center, or for home health care?

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For healthcare providers who are administering a prescription medication at their site, payments are facilitated through a claims administrator. You may submit claims electronically (preferred method), 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

How do I submit a pharmacy 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 portal, Member Card Lookup Tool or by viewing the patient’s Member Card.
Group Number: Reference patient search within portal, Member Card Lookup Tool or by viewing the patient’s Member Card.

RX BIN: 610600
PCN: AS
Processing Code: 08

Alpha Scrip
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 Alpha Scrip’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 Alpha Scrip’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 that are 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

How do I reset my password?

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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”

How do I request a Cost Exceeds Override for a claim for a patient?

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To request a Cost Exceeds 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.”

Can I view my coworker’s patients in the Provider Portal?

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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.

Will I be able to use the Provider Portal during reenrollment?

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During reenrollment, providers will be able to see when a patient submits a reenrollment request 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.

Can I add a patient to the Provider Portal if they are not enrolled in a TAF disease program?

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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.

Disease Program Waitlists

How can I get my patient added to a disease program 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 Health Care 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.

What information do I need to refer my patient to a TAF disease program waitlist?

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

If my patient doesn’t have an email address, can I still refer them to the waitlist?

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An email address is not required to join a disease program’s waitlist; however, patients must select one 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, if available, 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.

What happens after I refer my patient to the disease program waitlist?

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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.

Can I complete the disease program waitlist enrollment on behalf of my patient?

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No; enrollment in a TAF program requires patient acceptance of the program terms and conditions, as well as HIPAA acknowledgement. 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 you patient that your 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.

Can I accept my patient’s enrollment invitation?

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No; enrollment in a TAF program requires patient acceptance of the program terms and conditions, as well as HIPAA acknowledgement. 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 your 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.

How can I update my patient’s contact information on a disease program’s waitlist?

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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.

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