Get How Do I Fill The Argus Prescription Claim Form 1991-2025

Filling out the Argus Prescription Claim Form online can be a straightforward process with the right guidance. This comprehensive guide will assist you in completing each section of the form efficiently, ensuring all necessary information is provided accurately.

Follow the steps to complete the Argus Prescription Claim Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Part One, fill in your Subscriber ID, which can be found on your insurance card. Then, complete the subscriber's name and contact details, including the street address, city, state, and ZIP code.
3. Input the patient's name as it appears on the prescription and their date of birth in MM/DD/YY format. Indicate the patient's sex by checking the appropriate box for Male or Female.
4. Specify the patient's relationship to the subscriber by checking the relevant box (e.g., spouse, child) and explaining the relationship if you select 'Other'.
5. Certification is required; please sign in the indicated field to confirm that the information is accurate and that the patient is eligible for drug benefits.
6. If applicable, move to Part Two for Coordination of Benefits. Indicate whether your claim has been processed with another insurance carrier by checking 'Yes' or 'No'. If 'Yes', attach necessary documents like the Explanation of Benefits or pharmacy receipt.
7. Complete the required fields regarding the other insurance policyholder's name, employer, insurance company, and policy number. This will facilitate the coordination of benefits.
8. In Part Three, provide pharmacy information. Enter the pharmacy name, address, phone number, and Pharmacy ID (NCPDP number). Ensure accuracy as this information is critical to processing the claim.
9. Review the receipts to ensure they contain the necessary details like date of service, Rx number, NDC number, quantity, and the amount paid.
10. Once the form is fully completed, you may save changes, download the document, print it, or share it as needed.

Take the next step and start completing your documents online today.