Our commitment to supporting patient access

Adaptive Biotechnologies is the company that offers the clonoSEQ® Assay, a test for detecting and tracking measurable residual disease, the small number of cancer cells that may remain in your body during and after treatment for cancer.

Depending on the type of insurance you have, coverage for clonoSEQ testing may differ. Adaptive will bill your insurance company directly and work with your plan to obtain the proper level of coverage for clonoSEQ. If your insurance plan limits or fully denies coverage for clonoSEQ, Adaptive will appeal the claim when possible and work on your behalf to seek payment for testing.

In some cases, you may still have financial responsibility for clonoSEQ. Please call our Patient Support Team at 1-855-236-9230 to understand your potential financial responsibility, verify your coverage, or discuss payment plan options. Be sure to talk to your doctor about how clonoSEQ may fit into your treatment plan before initiating testing.

Medicare covers clonoSEQ testing performed on blood or bone marrow samples from patients with multiple myeloma, B-cell acute lymphoblastic leukemia or chronic lymphocytic leukemia, at multiple time points throughout a patient’s treatment. When there is reason to believe Medicare will not cover the test, you will be asked to review and sign an Advance Beneficiary Notice (ABN) informing you that Medicare considers the test to be noncovered, the reason why testing is not covered, and your financial responsibility, prior to any services being performed. For billing questions or to discuss the Adaptive Assist™ Patient Support Program, please contact our Patient Support Team at 1-855-236-9230.

Out-of-pocket cost estimates are available prior to submission of a clonoSEQ order by contacting our Patient Support Hotline at 1-855-236-9230. Please remember that any amount quoted during this process is an estimate based on plan benefits and unmet deductible or coinsurance and/or copay amounts and is subject to change based on other claims that are being processed for you.

During the call, we will attempt to qualify eligible patients for financial assistance through our Adaptive Assist Patient Support Program so that we can more accurately estimate the potential out-of-pocket costs.

To be eligible for financial assistance, a patient must meet all of the following criteria:

• Be a US citizen or legal resident age 18 years or older;
  – Patients under the age of 18 are eligible, but require the application form to be signed by a parent or legal guardian.
• Be uninsured or have insurance that does not cover the full cost of clonoSEQ testing;
• Meet financial need requirements based on the patient’s income and the number of persons in their household, or meet financial need based on medical expenses as a percentage of their household income, and;
• Submit a completed and signed Patient Support Program Application Form.
  – NOTE: Patients should be prepared to provide documentation supporting financial need if selected for the program’s eligibility verification process.

If desired, Adaptive can assist with the retrieval of archived pathology specimens. Requests for this assistance must be indicated in the Specimen Information section of the TRF. To enable pathology specimen retrieval, the patient’s complete pathology report must be included with the signed TRF.

If you have already received clonoSEQ testing, your insurance company will likely send you an EOB. The EOB is not a bill. It will show what was paid, what deductions were applied, and what part of the total cost is not covered by your insurance. If you have questions about billing or payment, please call our Patient Support Team at 1-855-236-9230.

If you received a payment directly from your insurance company for clonoSEQ testing, you are required to forward the payment and related Explanation of Benefits (EOB) to Adaptive Biotechnologies as the provider of these testing services. Please call our Patient Support Team at 1-855-236-9230 as soon as possible to learn how to forward the payment and necessary corresponding documents to Adaptive Biotechnologies.

If you have a financial responsibility for clonoSEQ testing, Adaptive Biotechnologies currently offers two payment options—online and by mail. To submit a credit card payment online, visit www.MyLabBill.com/SQ. To submit a payment via the mail, send a copy of your clonoSEQ patient statement along with a personal check or money order made out to Adaptive Biotechnologies to the address below.

Adaptive Biotechnologies
Dept LA 24084
Pasadena, CA 981185-4084

Adaptive Biotechnologies will perform an upfront eligibility verification process of patients applying for financial assistance. If selected to participate, you may receive a letter informing you that you initially qualified for assistance, but supporting documentation will be required to verify your application.

You will then be required to provide documentation demonstrating financial need within 45 days of notification that you have been selected for the verification process.

Once we review your application along with the documentation you provide, we will send you a letter regarding your program qualification outcome and your level of financial assistance, if applicable. Your approval for financial assistance will be valid for a period of one year.

If you have any questions regarding the Adaptive Assist^™ Patient Support Program, please call our Patient Support Team at 1-855-236-9230. Representatives are available Monday through Thursday 9AM to 7PM and Friday 9AM to 5PM EST.