Benefits Investigation

"We work hard on our patients'
behalf for their coverage, so they
don't have to"
- HPC Insurance Navigation Specialist

Let us do the legwork for you.

Fill out the fields below and upload a copy of your insurance card. An HPC Insurance Navigation Specialist will do an initial benefits review and they will contact you via phone with your coverage benefits.

Please select all that apply:

I am uninsured and have no current insurance and request patient assistance I am under insured and would like to request additional co-pay patient assistance I am requesting a benefits investigation to determine my coverage and Specialty Pharmacy options for my current therapy

First Name*

Last Name*

Phone Number*

Diagnosis

Upload a copy of your insurance card.

On my behalf, I hereby authorize HPC Specialty Pharmacy to file all claims for collection of payment for these services to my insurance company as applicable, to include Medicare, Medicaid or any unpaid balances on my claims will be paid by me to HPC Specialty Pharmacy.

On my behalf, I hereby authorize HPC Specialty Pharmacy the full ability to request and to collect directly all public and private insurance coverage benefits due for these products, services and equipment that will aide in treatment of my illness. In the collection process, HPC Specialty Pharmacy has my permission to request any medical records or copies of such that may be needed to ensure payment of these claims. I also authorize any of my insurance companies to pay directly to HPC Specialty Pharmacy and release any and all information to HPC Specialty Pharmacy as needed to ensure payment of claims.

Urgent Patient Concerns?

Speak to an HPC clinician any time of the day, 365 days per year: 1-800-757-9192

Patient Portal

Patient Portal

Benefits Check

Benefits Investigation

"We work hard on our patients'
behalf for their coverage, so they
don't have to"
- HPC Insurance Navigation Specialist

Let us do the legwork for you.

Urgent Patient Concerns?

Patient Portal

Patient Portal

Benefits Check

Benefits Investigation

"We work hard on our patients' behalf for their coverage, so they don't have to" - HPC Insurance Navigation Specialist

Let us do the legwork for you.

Urgent Patient Concerns?

"We work hard on our patients'
behalf for their coverage, so they
don't have to"
- HPC Insurance Navigation Specialist