Get the free ** Fee-For-Service Pharmacy Provider Notice #249 - Kentucky - chfs ky
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Aetna Better Health of Kentucky 9900 Corporate Campus Drive, Suite 1000 Louisville, KY 40223Date Name Address City, State Zip CodeAetna Better Health of Kentucky Prescription drugs Dear Member, We
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01
Obtain the fee-for-service pharmacy provider notice form from the appropriate source.
02
Read the instructions carefully before filling out the form.
03
Provide all the required information accurately.
04
Fill in your contact details, including name, address, phone number, and email.
05
Specify your pharmacy provider details, including name, address, and phone number.
06
Indicate the type of pharmacy services you offer.
07
Provide any additional documents or information as requested.
08
Review the completed form to ensure correctness and completeness.
09
Sign and date the form.
10
Submit the filled-out fee-for-service pharmacy provider notice as instructed.
Who needs fee-for-service pharmacy provider notice?
01
Pharmacy providers who are required to provide fee-for-service pharmacy services need to fill out the fee-for-service pharmacy provider notice. This may include independent pharmacies, retail chains, or other organizations that offer pharmacy services on a fee-for-service basis.
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What is fee-for-service pharmacy provider notice?
The fee-for-service pharmacy provider notice is a formal notification that outlines the services provided by pharmacies under a fee-for-service model, detailing reimbursement processes and guidelines.
Who is required to file fee-for-service pharmacy provider notice?
Pharmacy providers that participate in fee-for-service programs or those who bill Medicaid and Medicare must file the fee-for-service pharmacy provider notice.
How to fill out fee-for-service pharmacy provider notice?
To fill out the fee-for-service pharmacy provider notice, providers must complete required sections regarding their services, pharmacy identification, and financial information, ensuring all information is accurate and submitted through the appropriate channels.
What is the purpose of fee-for-service pharmacy provider notice?
The purpose of the fee-for-service pharmacy provider notice is to ensure transparency in billing practices, facilitate proper reimbursement, and maintain compliance with regulatory requirements.
What information must be reported on fee-for-service pharmacy provider notice?
Information that must be reported includes the pharmacy's name, address, provider number, services offered, and any relevant billing details or changes in ownership.
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