Philanthropic Patient Funding Services RFI UCSD Health

2026-11-03

• Vendor will conduct screening to identify and / or engage those patients who are eligible or potentially eligible for Philanthropic Patient Funding Services . • Vendor shall also perform daily screening of the schedule to identify patients that may be eligible for Philanthropic Patient Funding Services . • Vendor will work with UC San Diego Health ’ s staff to request permission from the patient to seek Philanthropic Patient Funding on their behalf and obtain an executed patient consent form . • Vendor will provide guidance and assistance to patients to offset the out - of - pocket cost of treatment for patients through philanthropic funding options , including co - pay assistance , premium assistance , and Patient Assistance Programs . • Retroactive Patient Balances a . Vendor will identify patients who have existing and outstanding balances that are eligible for retroactive assistance , obtain assistance for such patients , and secure payment through a range of philanthropic programs to mitigate or cover the patient ’ s balance . • Patient Assistance Programs ( PAPs ) a . Vendor will assist indigent uninsured and under - insured patients with obtaining free medication through manufacturer Patient Assistance Programs to eliminate financial loss to UCSDH , wherever possible . • Free Medication / PAP Maintenance : As part of providing Patient Assistance Program assistance to UCSDH patients , vendor shall a . Track , order , and assist in maintaining free medications obtained on behalf of the patient and UCSDH , including medication replacement after infusion , and obtaining medication prior to infusion ; b . Perform monthly review of all instances of infused medication to self - pay patients ; c . Prepare and submit medication replacement requests ; d . Advise pharmacy team of upcoming shipments of free medication and associated patient and treatment dates ; and e . Perform end - of - year submissions for new approvals in order to continue the program into the new year . • Copay & Foundation Payment Process : Vendor shall perform the following when providing copay or foundation program assistance for UCSDH patients who have been identified as being eligible for vendor ’ s program : a . Perform weekly checks of patient explanation of benefits (“ EOBs ”) to determine if any out - of - pocket costs are reported ; b . Submit EOBs and all other necessary reports to the philanthropic organization ; c . Follow up with copay / foundation program for payment until paid ; d . Perform end - of - year submissions for new approval in order to continue the program into the new year ; and e . Report payments via check number , copay card or EFT to a designated billing representative of UC San Diego Health for posting .

California

2026-03-27