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Birdi Patient Care Center18558738739 (TTY dial 711) or Patientcare@birdirx.com www.medimpact.comEnrollment/Medication Order FormMember Information Please use black or blue ink and CAPITAL LETTERS

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How to fill out medimpact direct mail order

01

Obtain the prescription from your healthcare provider.

02

Gather your insurance information.

03

Go to the MedImpact Direct website or call their customer service to create an account.

04

Fill out the online order form with the prescription and insurance information.

05

Choose your shipping and payment options.

06

Review the order and submit it for processing.

Who needs medimpact direct mail order?

01

Individuals who need to fill prescriptions on a regular basis.

02

People who prefer the convenience of having medications delivered to their home.

03

Anyone looking for a cost-effective way to order medications.

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What is medimpact direct mail order?

MedImpact direct mail order is a service that allows patients to receive their prescription medications directly at home, providing a convenient way to manage ongoing prescriptions.

Who is required to file medimpact direct mail order?

Patients using the MedImpact direct mail order service for their prescriptions are typically required to file the necessary forms to ensure their medications are processed properly.

How to fill out medimpact direct mail order?

To fill out a MedImpact direct mail order, patients must complete the order form provided by MedImpact, include their prescription details, and submit it along with payment information as directed.

What is the purpose of medimpact direct mail order?

The purpose of MedImpact direct mail order is to streamline the process of obtaining prescriptions by providing a reliable home delivery service, thereby improving medication adherence and patient convenience.

What information must be reported on medimpact direct mail order?

Important information that must be reported includes patient's personal details, prescription medication name and dosage, prescriber's information, and payment details.

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