Get Curascript Prescription Enrollment Direct Fax Form - Humana Military

Filling out the CuraScript Prescription Enrollment Direct Fax Form - Humana Military is a crucial step in ensuring that your prescription needs are met efficiently. This guide provides clear, step-by-step instructions to help you complete the form accurately and online.

Follow the steps to complete your prescription enrollment form

1. Press the ‘Get Form’ button to access and open the form in your preferred editing tool.
2. Fill out the patient information section, including the patient's name, address, date of birth, and contact numbers. Ensure all fields are completed accurately.
3. Indicate whether this is a new prescription or a refill by selecting the appropriate option.
4. Complete the statement of medical necessity, including the patient’s weight and primary diagnosis with the corresponding ICD9 code.
5. Select the appropriate drug delivery information, specifying whether it is for in-office delivery, home delivery for self-injection, or other methods.
6. Provide detailed insurance information, including the primary and secondary insurance details. Attach a copy of the patient’s insurance card if required.
7. Complete the doctor/prescriber information section, including their NPI number and DEA number if applicable.
8. Complete the prescription details section, including the date, drug name, strength, quantity, directions for use, and refills.
9. Obtain the necessary signatures from the doctor/prescriber for dispensing.
10. Review the completed form for accuracy, then save your changes, download, print, or share the form as needed.

Ensure you complete your documents online for a smoother process.