Instructions for Form F-13072 Noncompound Drug Claim - Wisconsin

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.