Get Wellcare Direct Member Reimbursement Form - Pdp

The WellCare Direct Member Reimbursement Form - PDP allows users to request reimbursement for covered prescription drugs purchased at full price. This guide provides clear, step-by-step instructions to ensure a smooth and efficient completion of the form online.

Follow the steps to complete the form accurately and efficiently.

1. Locate the ‘Get Form’ button to access the WellCare Direct Member Reimbursement Form - PDP and open it in your preferred document editor.
2. Begin by filling out the member information section. Include your name, date of birth, ID number, street address, apartment/unit number, phone number, city, state, zip code, and client ID.
3. In the reason for request section, indicate the appropriate reason for the reimbursement request by selecting from the options provided.
4. Proceed to the pharmacy/prescription information section. Ensure that you attach detailed prescription label receipts. You may ask your pharmacist to assist by completing the remaining information.
5. For each prescription, provide the drug name, date of fill, quantity, day supply, amount paid, and National Drug Code (NDC). Also include the prescribing doctor's name and their National Provider Identifier (NPI), along with the pharmacy's NPI and the prescription number.
6. Review all information for completeness and clarity. Verify that the prescription label receipt is legible to avoid delays or denial of your claim.
7. Complete the certification section by signing the form as the enrollee. If you are unable to sign, ensure that an authorized individual signs on your behalf.
8. Finally, mail the completed form along with the original prescription label receipts to the designated WellCare Reimbursement Department address.

Start completing your WellCare Direct Member Reimbursement Form - PDP online for timely reimbursement!