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Instructions for Form F-13072 Noncompound Drug Claim - Wisconsin
This document contains official instructions for Form F-13072 , Noncompound Drug Claim - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-13072 is available for download through this link.
FAQ
Q: What is Form F-13072?
A: Form F-13072 is a Noncompound Drug Claim form in Wisconsin.
Q: Who needs to fill out Form F-13072?
A: Pharmacies, physicians, and other providers who dispense prescription drugs in Wisconsin need to fill out Form F-13072.
Q: What is the purpose of Form F-13072?
A: The purpose of Form F-13072 is to submit claims for noncompound prescription drugs dispensed in Wisconsin.
Q: What information is required on Form F-13072?
A: Form F-13072 requires information such as the recipient's name, Medicaid ID, prescription details, provider information, and billing details.
Q: When should I submit Form F-13072?
A: Form F-13072 should be submitted within 180 days from the date of dispensing the prescription drug.
Q: How do I submit Form F-13072?
A: Form F-13072 can be submitted electronically through the Wisconsin Department of Health Services Electronic Data Interchange (EDI) System.
Q: Are there any fees associated with submitting Form F-13072?
A: No, there are no fees associated with submitting Form F-13072.
Q: What should I do if I have questions or need assistance with Form F-13072?
A: If you have questions or need assistance with Form F-13072, you can contact the Medicaid Pharmacy Help Desk.
Instruction Details:
- This 3-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Wisconsin Department of Health Services.
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