How to Use the Program

For Intravenous (IV) Product Patients

Receive your infusion.
Your doctor's office sends the Oncology Co-pay Assistance Program a copy of the detailed Explanation of Benefits (EOB). You may also complete this step.
- Your health plan automatically sends you the EOB after you receive your treatment
- The EOB may be faxed to (877) 885-2607
The Oncology Co-pay Assistance Program verifies your information. After verification of information and confirmation that program requirements are met, we load the co-pay amount minus the patient out-of-pocket responsibility.
- You pay the out-of-pocket (OOP) drug costs for your Genentech Oncology product.
- You pay the doctor's office, the hospital, the infusion center or your community/retail pharmacy, depending on where and how you receive your treatment
Claims must be submitted within 365 days from the date of service (DOS) for consideration

The SP will call you to collect your co-pay. When it does, give the SP your RxBIN, Member ID, Group Number and PCN.
Your Genentech Oncology product is mailed to you.

When you are told your order is ready, bring your RxBIN, Member ID, Group Number and PCN to the community/retail pharmacy to pick up your Genentech Oncology product.
Give your RxBIN, Member ID, Group Number and PCN to the pharmacist at the community/retail pharmacy. He or she collects your co-pay and uses your account information at the counter.

Download the Check Request Form from the Downloadable Forms section.
Complete the Check Request Form and send it to Genentech, along with copies of the detailed EOB and payment receipt. These can be sent via:
- Fax to (877) 885-2607
- Mail to
    Oncology Co-pay Assistance Program
    P.O. Box 2106
    Morristown, NJ 07962
A check is sent to the person named on the Check Request Form. This takes 7 to 10 business days.
Claims must be submitted within 365 days from the date of service (DOS) for consideration