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What is drug coverage review request

The Drug Coverage Review Request Form is a healthcare document used by physicians to request coverage for non-preferred medications like Actemra for patients with rheumatoid arthritis.

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Who needs drug coverage review request?

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Drug coverage review request is needed by:
  • Physicians requesting drug coverage for patients
  • Medical offices handling patient prescriptions
  • Pharmacists verifying medication coverage
  • Patients undergoing treatment for rheumatoid arthritis
  • Health insurance providers processing requests
  • Healthcare administrators in Nevada

How to fill out the drug coverage review request

  1. 1.
    Access the Drug Coverage Review Request Form on pdfFiller by searching for its name in the search bar and selecting the correct document.
  2. 2.
    Once open, familiarize yourself with the form layout. Look for sections that require input from both the physician and patient.
  3. 3.
    Before completing the form, gather all necessary information, including patient details, previous treatments the patient has tried, and their responses to those treatments.
  4. 4.
    Begin by entering the patient's full name, date of birth, and insurance details in the designated fields. Be sure to double-check the accuracy of these entries.
  5. 5.
    Next, move to the physician's section where you must provide your name, medical license number, and contact information.
  6. 6.
    Indicate whether the patient has previously tried other treatments. For this, check the appropriate boxes and provide additional notes if necessary.
  7. 7.
    Complete the signature line at the bottom of the form by signing and dating it as required. Ensure all indicated checkboxes are filled to avoid delays.
  8. 8.
    Review each section for completeness and accuracy. Make any necessary edits before proceeding.
  9. 9.
    Once you are satisfied with the information entered, save your work by clicking the save button. You can also download a copy for your records.
  10. 10.
    To submit the form, print it and fax it to the specified number provided in the instructions or follow any additional submission guidelines set by Express Scripts.
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FAQs

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The Drug Coverage Review Request Form is primarily for physicians seeking coverage for patients needing specific medications like Actemra. Patients with non-preferred medications may also benefit from this form.
It's important to submit the Drug Coverage Review Request Form promptly after determining a patient needs non-preferred medication. Delays can lead to interruptions in treatment; always check with Express Scripts for any specific timelines.
The completed Drug Coverage Review Request Form should be faxed to the number provided on the form. Ensure that all required information is included to prevent delays in processing.
Typically, supporting documents may include previous treatment records and any notes about the patient's medical history that may justify the need for the requested medication. Be sure to check any specific requirements from Express Scripts.
Common mistakes include missing patient or physician information, failing to provide accurate treatment history, and not signing or dating the form. Review all sections carefully to ensure completeness.
Processing times for the Drug Coverage Review Request Form can vary. Typically, you can expect a response within a few business days, but it's advisable to follow up with Express Scripts for more precise information.
If a coverage request is denied, you can review the denial notice for reasons and may submit additional documentation to support your case. Consider contacting Express Scripts for guidance on the appeals process.

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