How We Can Help

Lilly PatientOne Services

Update your billing and coding systems to include the permanent CYRAMZA® (ramucirumab) J-code: J9308, injection, ramucirumab, 5 mg. Issued by the Centers for Medicare & Medicaid Services (CMS), this permanent J-code is effective as of January 1, 2016.

How We Can Help

Lilly PatientOne Services

Call on us to help make access easier for your patients.

No two patients have the same financial or coverage situations. Lilly PatientOne provides a range of personalized services to help qualified* patients get the access and reimbursement assistance they need based on their individual situations. It takes only one application for everything from reimbursement and co-pay assistance to product replacement through the Lilly Cares Foundation, Inc., an independent nonprofit organization that provides free Lilly medications to qualifying patients.

Overview Insured Underinsured Uninsured
Insured Underinsured Uninsured
Conducts a benefits investigation to assist in verifying coverage
Describes prior-authorization requirements for patient’s insurer
Determines co-pays and cost sharing
Provides templates
/forms
/checklists for appeal if claim denied
Conducts status updates for appeals (if requested)
Provides information about co-pay assistance programs
Determines availability of alternate funding options
Transfers to a specific foundation upon request
Collects information on behalf of the Lilly Cares Foundation
If your patient is insured
Lilly PatientOne offers benefits investigation and appeals assistance
What to do:
1. If a patient’s claim is eligible, download a Lilly PatientOne application. Or call 1-866-4PatOne (1-866-472-8663) and we will send the form to you. As you fill out the form, be sure to check all services your patient might need, including the Lilly Cares Foundation in the event his or her claim is denied.
2. Fax the completed form to 1-877-366-0585. The treating physician will receive a response from Lilly PatientOne once the application is reviewed.
What to expect next:
3. Lilly PatientOne may:
  • Conduct a benefits investigation to help verify coverage
  • Provide prior-authorization requirements for the patient’s insurer
  • Provide templates, forms, and checklists for filing an appeal if a claim for an eligible Lilly Oncology product is denied. These forms are also available in the Forms section of this site
  • Provide status updates for appeals that have been filed for eligible Lilly Oncology products
4. If the appeals process does not result in a favorable decision after all appeals have been exhausted, we will screen the patient's eligibility for the Lilly Cares Foundation. You may need to submit a Dosage Tracking form, if applicable. Please fax it to 1-888-242-6230.
5. If your patient can’t afford his or her co-pay or coinsurance, Lilly PatientOne also provides information on co-pay assistance options.
If your patient’s insurance isn’t enough
Lilly PatientOne offers co-pay and coinsurance assistance
What to do:
1. For eligible patients, download and fax a Lilly PatientOne application to 1-877-366-0585. Or call 1-866-4PatOne (1-866-472-8663) and we will send the form to you. As you fill out the form, be sure to check all services your patient might need, including any available co-pay program for the prescribed Lilly Oncology product and the programs offered by the Lilly Cares Foundation, Inc., an independent nonprofit organization, in case additional help is needed.
What to expect next:
2. Lilly PatientOne may:
  • Assess the patient's needs and our ability to help
  • Conduct a benefits investigation to help verify coverage and patient financial responsibility for eligible products
  • Provide information on available co-pay assistance programs
  • Refer you to a charitable co-pay assistance foundation upon request. See a list of charitable foundations or contact a Lilly PatientOne representative at 1-866-4PatOne (1-866-472-8663) for this week’s updates
  • Screen the patient's eligibility for programs offered by the Lilly Cares Foundation
If your patient is uninsured
The Lilly Cares Foundation offers programs that provide Lilly Oncology products at no cost to qualifying patients.
What to do:
1. If your patient has been prescribed a Lilly Oncology product, is at or below 500% of the federal poverty level, and meets eligibility criteria for the Lilly Cares Foundation, download a Lilly PatientOne application and, if applicable, a Dosage Tracking form and/or a Certification of Brand Drug Usage form. Be sure to check the box on the application for the Lilly Cares Foundation.
2. Once completed, fax the forms and proof of income to 1-877-366-0585.
What to expect next:
3. Once the application and appropriate documentation have been submitted and reviewed by the Lilly Cares Foundation, you will be notified of your patient's application status.
  • Approved patients will be enrolled into a program offered by the Lilly Cares Foundation
  • Approved dates of service will be determined based on the submitted Dosage Tracking form
  • The Lilly Cares Foundation may send replacement vials for ongoing therapy to your office for approved patients
  • Lilly PatientOne also may evaluate the availability of alternate funding options if needed

Reimbursement programs for Lilly Oncology products are administered by an independent pharmaceutical services company in consultation with Lilly USA, LLC. These programs are available to members of the medical profession and/or patients prescribed an eligible Lilly Oncology product by request. Neither Lilly USA, LLC, nor the pharmaceutical services company guarantees insurance reimbursement, nor will either entity be responsible for filing any insurance claim. It is the responsibility of the patient and/or the patient’s physician to obtain all patient consents required for release of personal health information to the pharmaceutical services company. There is no obligation to prescribe any Lilly drug for program participation. Participating oncologists will not receive any type of reward or benefit for prescribing a Lilly drug. Lilly reserves the right to discontinue or modify reimbursement programs for Lilly Oncology products at any time, without notice.

Qualifications may vary depending on patient situations.

† Lilly PatientOne collects information on behalf of Lilly Cares to assist Lilly Cares with its charitable mission. For more information about Lilly Cares, please visit LillyCares.com.

‡ Uninsured patients are not eligible for foundation assistance.