How to use or fill out prescription reimbursement form uhs with our platform
- Click ‘Get Form’ to open the prescription reimbursement form uhs in the editor.
- Begin by entering your name and student ID number in the designated fields. Ensure that your Anthem Blue Cross ID is correctly formatted as U followed by your student ID (e.g., U12345678).
- Select your plan type by circling either M001 for graduate students, M002 for undergraduate students, or M003 for Filing Fee/Withdrawal/Concurrent Enrollment students.
- Fill in your date of birth in the specified format (mm/dd/yyyy) and indicate your gender by checking the appropriate box.
- Once all fields are completed, review your entries for accuracy before saving the document. You can then print it out or save it as a PDF.
- Submit your completed form along with prescription receipts via fax, email, or mail as outlined in the instructions provided on the form.
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