AccessHealth Enrollment Packet Frequently Asked Questions

1. How do I complete Page 2 of 12 for Payment / Remittance Address? – Leave this page blank.

2. On Page 14 for the Pharmacy Participation Disclaimer/ Pharmacy Affiliation Change Request - What do I put in the blank where it ask for the chain code? – Select Access Health Plus 605. The chain code is 605.

3. What effective date do I use throughout the enrollment packet? – Leave effective dates blank or use ASAP.

4. On Page 18, what option do I select for Banking Information – Select "New Member".

5. On Page 23 - NCPDP Pharmacy Affiliation Agreement– Only complete Section 1 and provide signature in Section 4.

6. On the last page - Termination Notice – Please select the first option if you are terming from APNS for contracts ONLY, but with to continue with APNS Value Added Programs.