Copay Support?

The Dalvance Connects® Copay
Assistance Program
may assist eligible patients with
their out-of-pocket costs for
DALVANCE, up to a maximum
benefit of $2000 per calendar year.

Contact Us

Phone Number 1-855-387-2824
Fax Number 1-855-888-7206



Access comprehensive reimbursement support services including real-time verification,
billing and coding support, and claim appeal support.
Patient Enrollment Form
HCP Enrollment Form
Coding & Billing Guide

The information provided in this site is intended for US healthcare professionals only.

Reimbursement Support Services through DALVANCE CONNECTS includes

·    Benefit Verification

·    Billing and Coding Support

·    Prior Authorization Research and Support

·    Claims Tracking

·    Claim Denial Appeal Support

Other Services include

·    Facility identification

·    Appointment Reminders

·    Patient Savings Program for commercially insured patients.