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Get Prometheus Links Program
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Open form follow the instructions
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How to fill out the Prometheus Links Program online
The Prometheus Links Program offers vital financial assistance to individuals requiring diagnostic tests. This guide will walk you through the online application process, ensuring that you can complete the form accurately and efficiently.
Follow the steps to successfully complete the Prometheus Links Program application
- Press the ‘Get Form’ button to access the application form and open it in the appropriate online editor.
- Begin by filling in your account number at the top of the form.
- Complete the patient information section by providing the full name, Social Security number, address, phone number, date of birth, and the number of members in your household as indicated on your most recent tax return.
- Indicate your residency status as a U.S. resident, including Puerto Rico and U.S. territories, by selecting 'Yes' or 'No'.
- Enter the annual gross household income before taxes and deductions in the designated field.
- Provide the state and zip code of your residence.
- Attach a copy of your most recent federal tax return (Form 1040) along with any other supporting documents you need to describe.
- Review the application declarations and ensure you understand the terms, then sign and date the application as the patient.
- If applicable, have the guarantor sign and date the form as well.
- Once all fields are completed, save your changes, and download, print, or share the form as needed.
Complete your application online today to access financial assistance.
For PROMETHEUS® Anser tests, denied insurance claim is assessed after PROMETHEUS Links appeal process is completed. The majority of people never pay more than $250. Some pay as little as $75. Your out-of-pocket cost is capped at $250.