How Do You Fill Out the Express-Scripts Fax Form?


Quick Answer

In order to fill out the Express Scripts fax form, you must first go to the company's website and download the online fax form. The form can then be printed, filled out by hand and faxed to Express Scripts for prompt fulfillment, notes the Express Scripts website.

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Full Answer

When submitting the fax form for a new prescription to Express Scripts, it is important to ensure all necessary information about the patient and the prescription being requested has been filled out; doing this will allow Express Scripts to avoid contacting the office to request more details, subsequently slowing down the fulfilment process. Information that is required includes the patients' name, date of birth, current mailing address and member ID number. Information that the prescribing physician is required to provide includes his name, NPI number and DEA number and an office telephone and secure fax number, states the Express Scripts website.

A completed and signed prescription form must be taped to the fax form and include a maximum of three refills. One separate fax form must be filled out for each prescription being requested, even if they are all for the same patient. A cover sheet is not needed when faxing the form over; however Express Scripts does require that the form be sent via an up-to-date, secure fax number says Express Scripts website.

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