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Click ‘Get Form’ to open the Gateway Health Plan® Pharmacy Direct Reimbursement Form in the editor.
In Part 1, enter your Member ID, Name, Date of Birth, Address, and Telephone Number. Ensure all information is accurate for smooth processing.
Sign the form to certify that the medication was received by you or the member listed. This acknowledgment is crucial for reimbursement.
Move to Part 2 and provide pharmacy information. Enter the pharmacy name, address, and telephone number where prescriptions were filled.
For each prescription (RX1 to RX4), fill in the date of service, prescription number, NDC number, amount paid, quantity, days supply, and prescriber name as indicated on your pharmacy receipt.
Review all entries for accuracy before submitting. Remember to attach an itemized pharmacy receipt that matches your entries.
Start filling out your Gateway Health Plan® form online for free today!
A not-for-profit organization, Gateway Health focuses on providing the best possible healthcare to a growing number of Medicaid and Medicare Advantage consumers by serving the needs of at-risk and vulnerable citizens with not only healthcare coverage but services such as disease management, health and wellness programs
Is Gateway Health Plan the same as Highmark WholeCare?
Gateway Health Plan, Inc. dba Highmark Wholecare.
Is Gateway the same as Highmark?
Pittsburgh-based Highmark Health Plan completed its acquisition of Gateway Health Plan on Sept. 7, ing to the Pittsburgh Post-Gazette.
What is Gateway Health called now?
Gateway Health plans will soon be Highmark Wholecare same access to doctors, same commitment to care and whole-person approach to health. All thats changing is the plan names. You can learn more about the transition to Highmark Wholecare, effective January 1, 2022, by visiting their website.
What is Gateway Health?
Gateway Health Management is a medical case management company that specializes in catastrophic injury management and employs some of the most experienced RNs in the country.
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