We have three options:

1.You may use e-prescribe to Birdi or fax to (888) 783-1773.

2.Your patient(s) may submit your prescription(s) to us via this website.

• First, create an online account here so you can send us a new prescription(s) or transfer current prescription(s) from a retail pharmacy.
• Second, choose "Request or Submit a New Prescription" at the top of the "My Medications" screen and follow steps.

3.Your patient(s) may submit your prescription(s) to us via mail:

• First, print and complete this Medication Order Form
• Second, print and complete this HIPAA Release Form
• Third, send both forms, along with your prescription(s), to:
  Birdi
  PO Box 51580
  Phoenix,AZ 85076-1580

Questions about mail-order medications?

Contact Birdi at (855) 873-8739 (TTY dial 711).

Download and complete the MedImpact Direct Specialty^® referral form. Fax the referral form, a copy of the patient's insurance card, and lab work to 1-888-807-5716.

What do the pharmacies in the MedImpact Direct Specialty^® Pharmacy Network provide?

Our network pharmacies provide clinical services for your patients and ship drugs to the location of your patient's choice. Our pharmacies contact patients each month to start a refill, review adherence, and answer questions. For each therapy, network pharmacies provide:

• Information to improve patient outcomes
• Outreach calls to help patients with therapy
• Patient education
• Patient-focused dispensing
• Help with side effects
• State-of-the-art care with accredited best practices
• Lab reviews
• Quality checks
• Coordination with doctor(s)

Questions about specialty medications?

Download the MedImpact Direct Specialty^® brochure for more information, registration, and ordering instructions. Or call MedImpact Direct Specialty^® at 1-877-391-1103 (TTY dial 711) 8:00 am to 8:00 pm Eastern Time, Monday-Friday.