Get the free Non-Formulary Drug Prior Authorization Form - Health Partners Plans
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PRIOR AUTHORIZATION REQUEST FORM EOC ID: Non-formulary drug r phone: 215-991-4300 Fax back to: 866-240-3712 r HEALTH PARTNERS manages the pharmacy drug benefit for your patient. Certain requests for
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What is non-formulary drug prior authorization?
Non-formulary drug prior authorization is a process where health insurance plans require healthcare providers to obtain approval before prescribing certain medications that are not on the plan's list of preferred drugs.
Who is required to file non-formulary drug prior authorization?
Healthcare providers such as doctors, nurses, and pharmacists are required to file non-formulary drug prior authorization.
How to fill out non-formulary drug prior authorization?
Non-formulary drug prior authorization forms can typically be filled out online or submitted through fax or mail. Healthcare providers need to provide clinical information justifying the need for the non-formulary drug.
What is the purpose of non-formulary drug prior authorization?
The purpose of non-formulary drug prior authorization is to ensure appropriate use of medications, control costs, and promote safe and effective prescribing practices.
What information must be reported on non-formulary drug prior authorization?
Information such as patient demographics, medical history, diagnosis, prescribed medication, dosage, and duration of treatment must be reported on non-formulary drug prior authorization.
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