Loading
Get Il Bcbs 12387 2003-2026
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the IL BCBS 12387 online
This guide provides clear and supportive instructions for filling out the IL BCBS 12387 online. Following these steps will help ensure accurate and timely reimbursement for your prescription drug claims.
Follow the steps to complete the form efficiently.
- Press the ‘Get Form’ button to obtain the IL BCBS 12387 form and open it in your chosen application.
- Complete Part 1: Member Information. Make sure to provide your Member ID number, Group number, Member name, address, city, state, ZIP code, and phone number. Include all original pharmacy receipts for quicker processing.
- Certify the information by signing and dating the space provided in Part 1, assuring the eligibility of the medication and that the claim is not for an on-the-job injury.
- If original pharmacy receipts are not included, Part 3 must be completed by the pharmacist. They will provide necessary details such as pharmacy name, prescription number, date purchased, drug name, quantity, and drug charge.
- After all sections have been filled out, review the information for accuracy. Ensure all required signatures are present.
Start completing your IL BCBS 12387 online now for efficient processing of your claims.
If you need to look up your insurance ID number, accessing your BCBS of Illinois member portal is the simplest method. Here you can find all your essential information. Alternatively, if you do not have access to the portal, contacting customer support directly can also provide you with the information you need. Keeping your ID number handy is key when managing your plan under IL BCBS 12387.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.