Get the free Opana (oxymorphone) PRIOR AUTHORIZATION FORM

This form is used to request prior authorization for coverage of Opana (oxymorphone) for treating moderate to severe pain, requiring documentation of previous medication trials and outcomes.

How to fill out opana oxymorphone prior authorization

How to fill out Opana (oxymorphone) PRIOR AUTHORIZATION FORM

1. Obtain the Opana (oxymorphone) Prior Authorization Form from your insurance provider's website or your healthcare provider.
2. Fill in the patient's personal information, including full name, date of birth, and insurance policy number.
3. Provide details about the prescriber, including their name, contact information, and NPI number.
4. Indicate the specific diagnosis or medical condition that requires treatment with Opana.
5. Document the patient's medical history related to pain management and previous treatments attempted.
6. Include the prescribed dosage and frequency of Opana, including any prior medications tried and their outcomes.
7. Attach any relevant medical records or documents that support the necessity of Opana for the patient's treatment.
8. Review the completed form for accuracy and completeness.
9. Submit the form to the insurance company via fax or online submission, following their specific guidelines.

Who needs Opana (oxymorphone) PRIOR AUTHORIZATION FORM?

1. Patients who are prescribed Opana (oxymorphone) and whose insurance requires prior authorization for opioid medications.
2. Physicians or healthcare providers prescribing Opana to ensure that patients receive coverage for their medication.

People Also Ask about

Which is stronger, oxymorphone or oxycodone?

Oxymorphone is a semisynthetic μ-opioid agonist, which is twice as potent as oxycodone for pain relief. Oral formulations of oxymorphone were reintroduced in the United States in 2006.

What formulations does oxymorphone come in?

Oxymorphone is available for parenteral injection (Numorphan®: 1 and 1.5 mg/mL), suppository (Numorphan®: 5 mg), oral IR tablets (Opana®: 5 and 10 mg), and oral ER tablets (Opana® ER: 5, 10, 20, and 40 mg).

What forms are available for oxymorphone?

The structural similarities between the µ-receptor antagonist naloxone and the agonist oxymorphone have been used to study and develop new agonists and antagonists. Oxymorphone is available in the United States in oral, injectable, and forms (Numorphan).

Is oxymorphone and OPANA the same thing?

In June 2006, Food and Drug Administration (FDA) approved immediate-release (IR) and extended-release (ER) oxymorphone oral tablets under brand names Opana® and Opana ER®.

What strengths do oxymorphone tablets come in?

Oxymorphone is indicated for the relief of moderate to severe pain. It is currently marketed both as immediate release tablets containing 5 mg or 10 mg and as extended release tablets containing 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg, 30 mg, or 40 mg oxymorphone hydrochloride.

How is oxymorphone administered?

Oxymorphone comes as an immediate-release tablet and as an extended-release (long-acting) tablet to take by mouth on an empty stomach, at least 1 hour before or 2 hours after meals. The immediate-release tablet is usually taken every 4 to 6 hours as needed for pain.

Is oxymorphone still available?

Although Opana ER® is no longer marketed in the U.S., generic formulations of ER and immediate-release oxymorphone products are still available.

For pdfFiller’s FAQs

What is Opana (oxymorphone) PRIOR AUTHORIZATION FORM?

The Opana (oxymorphone) PRIOR AUTHORIZATION FORM is a document that healthcare providers submit to insurance companies to obtain approval before prescribing the medication Opana, which is used for pain management.

Who is required to file Opana (oxymorphone) PRIOR AUTHORIZATION FORM?

Healthcare providers, such as physicians or pharmacists, are typically required to file the Opana PRIOR AUTHORIZATION FORM on behalf of patients who need this medication and whose insurance plan requires prior authorization.

How to fill out Opana (oxymorphone) PRIOR AUTHORIZATION FORM?

To fill out the Opana PRIOR AUTHORIZATION FORM, providers must include patient information, diagnosis, treatment history, and justification for the use of Opana, along with any relevant medical records or supporting documentation.

What is the purpose of Opana (oxymorphone) PRIOR AUTHORIZATION FORM?

The purpose of the Opana PRIOR AUTHORIZATION FORM is to ensure that the medication is medically necessary for the patient and to control costs by requiring insurance companies to review the treatment plan before approving coverage.

What information must be reported on Opana (oxymorphone) PRIOR AUTHORIZATION FORM?

The information that must be reported on the Opana PRIOR AUTHORIZATION FORM includes the patient's demographics, provider details, medical diagnosis, previous treatment attempts, expected duration of therapy, and rationale for prescribing Opana.