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Resources

Members

At-Home COVID-19 Test Options
Member FAQs
EpiphanyRx Member FAQs
Over-the-Counter (OTC) COVID-19 Tests FAQs
Formulary and Drug Lists
EpiphanyRx Formulary
EpiphanyRx ACA Preventive Drug List
EpiphanyRx HSA Preventive Drug List
EpiphanyRx Maintenance Drug List
Home Delivery Information
Home Delivery Flyer
Costco Patient Profile Form
Visit Costco Pharmacy
Reimbursement Claim Forms
EpiphanyRx Member Reimbursement Form
EpiphanyRx Compound Claim Reimbursement Form
EpiphanyRx COVID-19 Test Claim Form
Other Forms
Release of Information Form

Providers

Prior Authorization Form
Payer Sheet
Pharmacy Network Application and Credentialing Form
Pharmacy Manual
MAC Appeal Form
Exception to Coverage Request
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