Billing, Insurance, and Financial Support

Patients who have health insurance may still be required to pay for part of their care costs, called the patient cost share. This cost share is outlined in the Explanation of Benefits (EOB) you receive from your insurance company. The EOB arrives separately from your bill and explains how much we billed your insurance company for the medication and services AIS Healthcare provided, and how much your insurance company will cover. You may receive a bill from AIS Healthcare for your patient cost share, which is determined by your insurance plan. If you have any questions, please call our Financial Concierge Team at 877.299.4371.

Medication and services from AIS Healthcare are part of your Medicare Part B benefits. However, Medicare does not reimburse all pharmacy services. Medicare requires us to bill the patient. If you have any questions, please call our Financial Concierge Team at 877.299.4371.

Being an in-network provider allows us to work directly with your insurance company to process claims. Your insurance company will pay us directly for your medication and services. If there is a patient cost share, we will send you a bill.

AIS Healthcare is working to become an in-network provider with many insurance companies. However, we provide medication and services to out-of-network patients as well. If you have any questions, please call our Financial Concierge Team at 877.299.4371.

AIS Healthcare is a compounding pharmacy specializing in high-risk implanted infusion pump medications (also known as “targeted drug delivery”). This means we receive prescriptions for patients from their physicians and then prepare medications to meet those exact physician specifications. We ship the medication pre-filled in a syringe so the patient’s implanted pump can be filled. We charge what’s called a per diem for each day the pump is infusing the medication into a patient’s body. Per diems are industry standard charges that pharmacies use to help defray the costs of compounding the medication. Costs include (i) providing care coordination, (ii) providing pharmacy support, (iii) ensuring high safety and quality testing of the compounded product so each medication syringe is terminally sterilized and free from any contaminants, and (iv) shipping the medication nationwide. Per diems are the preferred method of billing for the TDD therapy by many insurance companies.

AIS Healthcare offers a Financial Assistance Program (FAP) to help eligible AIS Healthcare patients who have concerns about being able to afford their medication. This could include those who do not have enough health insurance or are not able to get government help, as well as those who are not able to pay for needed care based on their financial situation.

To apply, call us at 877.299.4371, option 2, or download and complete this form.

An Explanation of Benefits (EOB) is not a bill. It is the administrative paperwork from your insurance company regarding how your plan benefits were applied. If you have any questions, just give us a call.