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STATE OF WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES BUREAU FOR MEDICAL SERVICES Office of Pharmacy Service Prior Authorization Criteria Offend (ospemifene) Prior Authorization Request
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Proposed criteria for coverage refers to the set of rules or requirements that insurance companies use to determine what services and treatments will be covered under a policy.
Insurance companies are required to file proposed criteria for coverage with their regulatory body.
Proposed criteria for coverage can be filled out by providing detailed information about the services, treatments, and conditions that will be covered under a policy.
The purpose of proposed criteria for coverage is to ensure transparency and clarity in what services and treatments are covered under an insurance policy.
Information that must be reported on proposed criteria for coverage includes details about covered services, treatments, exclusions, limitations, and any pre-authorization requirements.
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