Welcome to Adstiladrin Copay Portal for Providers
Submit co-pay claims for in-office administered therapy.

To submit a medical co-pay claim you will need:

• Explanation of Benefits (EOB) form for insured patients
• Specific information regarding the patient, prescriber, date of therapy administration, etc.

Please note: You may only submit a claim if the patient is commercially insured and is not participating in Medicare Part D, VA, TriCare, CHAMPUS, Medicaid, or any other similar federal or state program.