Welcome to the Patient Advocate Foundation Co-Pay Relief Program’s
(CPR) secured, on-line Provider Center!
For your convenience the online Provider Center is available 24 hours, and you may submit application an on behalf of a patient you are serving through this secure website. Once you have fully completed the application, including all required fields of data, you will be notified immediately if your patient is eligible for assistance from CPR. If your patient is eligible for assistance, the application will be instantly approved and you will have immediate program access. This application process should take approximately 7-10 minutes to complete.
To insure the continued integrity of the program, all patients approved for assistance are required to have a physician verify his/her diagnosis by completing and signing a Physician Verification Form and submitting it to the CPR program within 30 days of the patient’s approval date. Additionally, certain patients will be randomly selected to submit documentation to verify reported income. Patient applications that are selected to submit income documentation are notified of this requirement immediately upon approval of the application for assistance and will have 30 days from their approval date to submit their documentation.
If this is your first time visiting the Co-Pay Relief Provider Center and you would like to register, please click Register. Please note that the practice NPI number, EIN/Tax ID number and a valid email address are required to complete the registration process. After registering, you will receive an email to confirm your registration and create your password. Your account will not be active until you have confirmed your registration and created your password. Once this is done, you can log in any time with your email address and password.
If you would like to begin the application process, please click Start.
Portal User System Requirements include:
Google Chrome 30.0.15 or higher
Adobe Reader 9 or higher version
File size uploads are limited to 2MB
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