Get Procedure Mac Process Form Catamaran Rx

Completing the Procedure Mac Process Form Catamaran Rx online is straightforward and allows users to appeal claims efficiently. This guide will walk you through each section of the form to ensure all required information is accurately submitted.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the document and open it in your online editor.
2. Begin with the provider information section. Enter the pharmacy or provider's full name, NCPDP ID, and NPI. Additionally, provide the contact person's name, phone number, fax number for response, and email address.
3. Next, fill out the member information section. Input the last name, first name, middle initial, member ID, Rx number, and date of birth for the person involved.
4. Proceed to the claim information section. Choose the appropriate option for brand or generic. Complete the fields with the claim authorization number, PCN, BIN, NDC, submitted group, claim fill date, quantity dispensed, product name, invoice price, product strength, drug form, and any comments you may have.
5. It is mandatory to submit an invoice showing the NDC of the claim being disputed along with this form.
6. Once all fields are completed, ensure there are no missing entries as incomplete forms will not be reviewed. Save your changes, then download, print, or share the completed form as needed.

Submit your documents online today to ensure timely processing of your appeal.