Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Patient Access Network Foundation (PAN Foundation) before sending sensitive documents. FaxFlow is not affiliated with this organization.

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Patient Access Network Foundation (PAN Foundation) fax number

(844) 726-4728

Medical Claims

Used for: Submitting medical expense claims and reimbursement requests to PAN Foundation (medical claims).

Fax destination details

Department
Medical Claims
Purpose
Submitting medical expense claims and reimbursement requests to PAN Foundation (medical claims).
Form
Direct Member Reimbursement Form (DMR) — Direct Member Reimbursement Form
Address
PAN Foundation, PO Box 2955, Clinton, IA 52733
Voice phone
1-866-316-7263

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fill out patient details and PAN ID; attach required documents (HCFA-1500/UB-04/UB-92 and EOB as applicable); indicate claim details; fax the form with the PAN Medical Claims Fax Cover Sheet to 844-726-4728.

Official form instructions are published as a downloadable file on the organization's website.

Sources and verification

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