Thank you for your interest in the OneTouch® Ping® glucose management system. This two-part system, an insulin pump and meter-remote, works to help you perform at your best.
We are here to help you during your decision-making process. In order to move forward and to learn if insulin pump therapy is right for you, we need to request certain information that will help us serve you better.
Our Inside Sales Department will help you with every step of the insurance process. Your insulin pump consultant will determine your benefits and then act on your behalf throughout the insurance authorization process.
There are three easy steps to get started:
1. Download the form and print
Get the Patient Information & Assignment of Benefits (AOB). You'll need Adobe® Reader® to view & print these files
2. Fill out the Patient Information & Assignment of Benefits (AOB) Form.
Patient Information Section: This section provides us with the information we need if you want to proceed with obtaining an insulin pump. Please complete as much of this section as possible.
AOB Section: This section gives Animas permission to contact your insurance company, contact your physician and help you throughout the insurance process. A pump specialist determines your benefits, then acts on your behalf to gain insurance authorization. Filling out the AOB does not obligate you to purchase a pump in any way.
*Please note: all fields are required in the AOB section of this form, including date. Failure to complete in its entirety may prolong the process.
3. Fax or mail your form
Fax: 1 (877) 331-7300
Mail: Animas Corporation | 200 Lawrence Drive | West Chester, PA 19380
Once the paperwork is processed, we’ll ship your pump and contact you to help you get started with training.
For international requests, please contact your local Animas Corporation division or distributor.