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Page 1-Page 1 of 1 Alabama Medicaid Pharmacy Prior Authorization Request Form FAX: (800) 748-0116 Phone: (800) 748-0130 Fax or Mail to Health Information Designs Page 1 of 2 P.O. Box 3210 Auburn,
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Alabama Medicaid Pharmacy Prior Authorization is a process by which prescribers must obtain approval from the Alabama Medicaid Agency before certain medications can be dispensed to Medicaid recipients.
Prescribers, such as doctors, nurse practitioners, and physician assistants, are required to file Alabama Medicaid Pharmacy Prior Authorization requests.
To fill out Alabama Medicaid Pharmacy Prior Authorization, prescribers need to complete a specific form provided by the Alabama Medicaid Agency, providing information about the patient, the prescribed medication, and the medical necessity for its use.
The purpose of Alabama Medicaid Pharmacy Prior Authorization is to ensure that Medicaid recipients receive appropriate and cost-effective medication therapy.
The information that must be reported on Alabama Medicaid Pharmacy Prior Authorization includes details about the patient, such as their Medicaid ID, diagnosis, and medical history, as well as information about the prescribed medication, such as its name, strength, dosage, and duration of therapy.
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