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Adaptive assist™

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How we help:
Tailored support for different patient needs

UNDERSTAND
COVERAGE

NAVIGATE
INSURANCE

INDIVIDUALIZED
SUPPORT

Our commitment to supporting patient access

Adaptive Biotechnologies understands that each patient’s situation is unique. We are committed to providing guidance and support during each step of the insurance process.

Why we offer Adaptive Assist Patient Support Program: to help facilitate access to clonoSEQ® testing services for lymphoid cancer patients who could benefit from the clinical insights provided by measurable residual disease (MRD) testing.

Adaptive Assist™ Application Form

ADAPTIVE ASSIST
APPLICATION FORM

ENGLISHSPANISH

Adaptive Assist Patient Support Program

A comprehensive reimbursement support program to support patients for the duration of their MRD testing.

  • Aid patients to understand the billing process and potential out-of-pocket costs
  • Assist with prior authorizations for all incoming clinical orders
  • Appeal for the maximum benefits and lowest out-of-pocket cost
  • Assist with out-of-pocket costs after coverage

Service Enhancements

Out-of-pocket cost estimates
For patients and caregivers needing to determine the potential out-of-pocket costs for clonoSEQ testing, we can perform a benefits investigation (BI) prior to order submission.

Prior authorization
Adaptive will evaluate all orders for the need for prior authorization and follow up as needed.

To use the out-of-pocket cost estimates service, please call our Patient Support Team at 1 (855) 236 9230 or email us at reimbursement@adaptivebiotech.com.

How to apply

Here is what you can expect when we work with you, your healthcare team,
and/or your health insurance plan.

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STEP 1:
ELIGIBILITY ASSESSMENT

Call our hotline to discuss your individual circumstances and to see if you might qualify.

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STEP 2:
APPLICATION

Complete and submit the Adaptive Assist Patient Support Program application to apply.

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STEP 3:
QUALIFICATION

Adaptive will notify you of your qualification status and work with you to find appropriate support.

How do I make a payment?

We currently offer two convenient payment options—online and mail.

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ONLINE

To submit a credit card payment online, visit: www.MyLabBill.com/SQ

Mail icon

MAIL

To submit a payment by mail, send a copy of
your Adaptive patient statement along with a check or money order to:

Adaptive Biotechnologies
Dept LA 24084
Pasadena, CA 91185-4084

Need more help?

Speak to one of our expert Patient Support Team members to get answers to your questions.

Call our help hotline at:
1 (855) 236-9230
Monday through Thursday 9am to 7pm and Friday 9am to 5pm EST

Support Resources

Access the resources below to learn more about the Adaptive Assist patient support program, review answers to a list of commonly asked questions, and apply for financial assistance.

Adaptive Assist™ Application Form

ADAPTIVE ASSIST APPLICATION FORM

English
Spanish

Adaptive Assist™ Program Brochure

ADAPTIVE ASSIST PROGRAM BROCHURE

English
Spanish

Adaptive Assist™ FAQ for Patients

ADAPTIVE ASSIST FAQ: FOR PATIENTS

English
Spanish

Adaptive Assist™ FAQ for Clinicians

ADAPTIVE ASSIST FAQ: FOR CLINICIANS

English
Spanish

Frequently Asked Questions

Who is Adaptive Biotechologies?

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

Is clonoSEQ testing covered by my insurance plan?

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.

Is the clonoSEQ Assay covered by Medicare?

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.

Can I find out what my potential out-of-pocket cost for the test will be?

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.

Who is eligible for financial assistance through the Adaptive Assist Patient Support Program?

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.
I received an Explanation of Benefits (EOB) from my insurance company for clonoSEQ testing. What should I do now?

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.

What if my insurance company paid me directly for clonoSEQ testing?

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.

What are my payment options if I have a balance due?

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 91185-4084

What documentation may be required to determine if you are eligible for financial assistance?

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.


This page is intended for a US-based audience.

clonoSEQ® is an FDA-cleared test used to detect minimal residual disease (MRD) in bone marrow from patients with multiple myeloma or B-cell acute lymphoblastic leukemia (B-ALL) and blood or bone marrow from patients with chronic lymphocytic leukemia (CLL). clonoSEQ is also available for use in other lymphoid cancers and specimen types as a CLIA-validated laboratory developed test (LDT).

clonoSEQ is only available by prescription from a licensed healthcare professional. Results may vary. Talk to your healthcare provider to see if clonoSEQ testing is right for you. For important information about the FDA-cleared uses of clonoSEQ including test limitations, please visit clonoSEQ.com/technical-summary.