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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 (ophthalmic emulsion 0.05%) Prior Authorization
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What is proposed criteria for coverage?
Proposed criteria for coverage is a set of guidelines or requirements that must be met in order to qualify for insurance coverage.
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Insurance companies or policy providers are required to file proposed criteria for coverage.
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The purpose of proposed criteria for coverage is to set standards and ensure that individuals or entities meet the necessary qualifications to receive insurance coverage.
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Information such as medical history, risk factors, and previous insurance coverage may need to be reported on proposed criteria for coverage.
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