Electronic submission of Prescription Drug expenses by your pharmacist will be possible in many situations. When you enroll into the Plan, you will receive a Certificate of Insurance that has your certificate and group number on it. You and your eligible dependants will use those numbers when claiming benefits at the pharmacy.
It is important that your pharmacist has this information. Without it, they will not be able to process an eligible claim electronically.
In most cases, your pharmacist will submit your prescription claim electronically at the pharmacy. AFBS works with ClaimSecure to provide Members and their covered dependants with pay-direct claims payments for Prescription Drug coverage. Since these claims are processed through the ClaimSecure network, the pharmacy requires the information contained on your Certificate of Insurance in your insurance package to process your claim.
If your pharmacist cannot file claims digitally at the time of service,* you will be able to submit your claims via the ClaimSecure eProfile™ app or on their website.
When submitting a claim online, you can either upload a photo (PhotoClaim) or input all relevant information (eClaim).
Electronic submission by your pharmacist is not possible for all prescription drug claims. For example, most compound prescriptions cannot be submitted electronically by your pharmacist.
When this happens, please submit a claim online using the ClaimSecure eProfile™ app or their website or send the original official receipt from the pharmacy with a completed Prescription Drug Claim Form to AFBS by mail. Your pharmacist will let you know when they cannot file your claim and you need to submit yourself either online or by mail.
Back to topIf AFBS is the second payor, please include the receipt of the claim settlement information, often called an Explanation of Benefits (EOB), from the other insurance company along with all relevant documentation (including a completed Prescription Drug Claim Form) and copies of your official receipts from the pharmacy when sending by mail.
Back to topClaims for a previous Benefit Year must be submitted within 90 days of the close of the Benefit Year indicated on your Certificate of Insurance to remain eligible for payment. When coverage is terminated AFBS must receive your claim submissions within 30 days of your coverage termination.
Back to topClaimSecure is a third-party service provider that AFBS works with to provide online claims submission for extended health care, and electronic pay-direct claim settlement for prescription drugs and dental care claims.
AFBS wants to provide your reimbursement to you as quickly as possible and we encourage you to submit your claims online using the ClaimSecure eProfile™app or their website when possible to speed up this process.
*Electronic submission by your pharmacist is not possible for all prescription drug claims, for example certain compounds or coordination of benefits scenarios. These must be submitted by mail with a completed Prescription Drug Claim Form. Special authorization drugs follow a certain protocol, for more information click here. Back to top