Bcbsnc Prescription Claim Form

Video Tutorial How to Fill Out bcbsnc prescription claim form

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Questions & answers

Most Blue Cross NC members should not need reimbursement for their OTC COVID-19 tests.When submitting a claim to be reimbursed, members must mail a: Completed OTC COVID-19 test claim form* Purchase receipt documenting the date of purchase and the price of the test. The test's UPC code.
How do I submit a claim? If your provider or pharmacy is in your plan's network, they'll submit the claim for you. If you saw an out-of-network provider, you'll need to submit a medical claim form. If this was for emergency care, call us first at 800-352-2583 to see if a claim was filed.
The Healthy Blue + Medicare Payer ID is North Carolina - 00602.
Visit BlueCrossNC.com/Claims for prescription drug, dental and international claim forms, or call the toll-free number on your ID card. Important Notes When Completing the Claim Form: Type or use blue or black ink to complete. Complete a separate claim form for each covered family member.
OptumRx and BriovaRx are subsidiaries of UnitedHealth Group. UnitedHealthcare and the dimensional U logo are trademarks of UnitedHealth Group Incorporated. All other trademarks are the property of their respective owners.
(OptumRx Mail Service) 6800 W 115th St, Suite 600 Overland Park, KS 66211-9838 NCPDP: 17188634 Call 1-800-791-7658 – Provide a verbal prescription directly to an Optum Rx provider dedicated pharmacist. Fax 1-800-491-7997 – Send a complete prescription using the Physician Fax Form.