what claim form is used for medicare advantage
MEDICARE PART D DRUG CLAIM FORM. INSTRUCTIONS. â¢ To process your claim as quickly as possible, please. provide all information requested. â¢ Ask your pharmacist for the drug information on this. form. Prescription receipts or a pharmacy-generated. drug summary must be attached. Cash register receipts. are not acceptable. â¢ Find your identification number on your member ID card. â¢ Use a separate claim form for each patient and pharmacy. â¢ If you are submitting more than two prescription claims, please use a new claim form. â¢ Fill out all fields for each submitted prescription.