Help center > Article:
Claims guide – Virology testing grants
Claims guide – Virology testing grants
What this grant pays for
You can use your virology testing (health equity) grant to help pay for:
- Out-of-pocket copays, coinsurance, and deductibles
- Clinical diagnostic procedures that identify the virus causing an infection (such as a respiratory virus, enteroviruses, and many others)
- Monitoring viral load in chronic disease (such as HIV, HCV, and HBV)
- Measuring viral infection or reactivation after transplantation and in other immunocompromised patients
You cannot use your grant to help pay for:
- Medication copays, coinsurance, and deductibles
- Health insurance premiums
- Office visit charges the day of treatment
- Administration charges related to treatment
- Dental, vision, or life insurance premiums
- Medical services such as lab work, radiation therapy, scans, and surgery
Paying for covered expenses
Payments
You can be reimbursed (paid back) for covered expenses or have TotalAssist pay a healthcare provider or treatment center (such as a hospital or clinic) directly. Payments to you are sent in the form of check by mail, or by EFT if you have signed up for EFT.
Electronic Funds Transfer (EFT)
If you want to have reimbursements directly deposited into your checking account, sign up for Electronic Funds Transfer (EFT) with TotalAssist. We recommend signing up when you get your approval letter; processing your sign-up can take a few weeks.
Period of time covered
You can submit claims for covered expenses incurred during your entire grant eligibility period. The grant eligibility period includes a lookback period of 6 months prior to your approval date, through your grant expiration date (12 months from approval date). Expenses incurred before your date of diagnosis are not eligible as covered expenses.
Who can submit claims
You can submit claims yourself, or your provider or pharmacy staff can submit claims on your behalf to TotalAssist. All claims are processed in the order they are received, regardless of how they are submitted.
How to submit a claim
Claim form – when submitting a paper form by fax or mail
- Your specific claim form contains a barcode that identifies you in our system. A paper copy is included in your welcome packet in the mail. Please make copies of your barcoded blank claim form so you have some ready to use.
- Remember to sign your claim form before submitting.
Claims in your portal account
- You can complete and submit a claim in your portal account. There is no paper form for this method of submitting a claim.
- Gather required supporting documents for the claim. All documentation must include your name. Handwritten supporting documentation is not accepted.
- View list of required supporting documents
- Submit your claim in your portal account with supporting documentation attached, anytime 24/7.
– or – - Submit your claim by fax or mail. Your claim should include your completed and signed barcoded, patient-specific claim form, plus copies of your supporting documentation. Submit to:
- Fax to: 757-952-0119
- Mail to: TotalAssist, 421 Butler Farm Rd, Hampton, VA 23666
Required supporting documents
All of the following are required with your submitted claim.
Your barcoded, patient-specific claim form—completed and signed. Please do not forget to sign your claim form.
Copy of the bill or itemized statement from your healthcare provider, which must include:
- Your name
- Provider name
- Remit address (if we are paying your provider directly)
- Date of service (DOS)
- Procedure codes
- Amount paid by insurance
- Your financial responsibility
Copy of your Explanation of Benefits from your health insurance company, which must include:
- Your name
- Insurance name and logo
- Date of service (DOS)
- Procedure codes
- Amount paid by insurance
- Your financial responsibility
Proof of payment (only if requesting reimbursement). Must include your name printed on the item; handwriting is not accepted. Any of the following:
- Receipts
- Bank or credit card statements
- Cancelled checks
- Itemized statements showing payments made by you
Please make sure all required documents, and your signed, completed claim form, are submitted with your claim. Your claim could be delayed or denied if required documents are missing, if your signature is missing, or if you did not use your patient-specific claim form.
Need more help?
Chat live or call 866-512-3861, Mon - Fri, 8:30am - 5:30pm ET.
Portal login for patients, pharmacies, and providers
Apply and manage claims 24/7
Portal login for nonprofit patient partners
Apply and manage claims 24/7
Published:
|
Last updated: