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MEMBER REIMBURSEMENT FORM 1231 East Beltline, NE Grand Rapids, MI 49525-4501 SECTION 1 - MEMBER INFORMATION Member Name Contract Number (with suffix) Address City State Zip Code SECTION 2 - INSTRUCTIONS.

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Our preferred pharmacies include: Albertsons/Safeway. Big Y Foods. Costco.

We partner with Express Scripts, the nation's largest pharmacy benefits manager, so you can get the most competitive rates.

Paper claims should be mailed to: Priority Health Claims, P.O. Box 232, Grand Rapids, MI 49501. Electronic claims set up and payer ID information is available here. To expedite claims processing, always include the member ID number (found on the member's ID card) to identify the patient.

As a PBM pharmacist, you fill prescriptions on behalf of a pharmacy benefit manager, which is a person or company that helps manage a program to provide a group of people typically employees at one company with prescription drugs.

As a nonprofit company, Priority Health serves more than 600,000 people and continues to be rated among the best health plans in the nation by the National Committee for Quality Assurance.

Call the number on the back of your Priority Health membership ID card to reach an expert in your plan. Or call Customer Service at 800.942. 0954.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232