Prescription Claim Reimbursement

Procedure for manual processing of prescription claims.

FlexScripts members, wishing to be reimbursed, or have applied to their deductibles, prescriptions that were paid out of pocket should submit the following information for manual reimbursement of claims:

  1. The original pharmacy receipt (not a cash register receipt) or a printout that includes the Prescription Number(s), Date(s) of Service, Drug Name(s), NDC Number(s), Quantities, Days Supply, and Amount(s) Paid.
  2. Group/Employer Name or Number
  3. Policy Number
  4. Patient Name
  5. Reason that prescription card was not used at the time of service.

If this is a request for a coordination of benefits (COB) with another insurance carrier, please be sure to submit the corresponding explanations of benefits (EOB) along with the pharmacy information.

Mail the requested information to:

FlexScripts Administrators
Attn: Kathy 
1205 South 70th street
Suite 702
West Allis, WI 53214

Or fax it to: 414-302-9837