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PRIOR AUTHORIZATION REQUEST FORM EOC ID: SW Exchange Formulary Drug Request Phone: 8007287947 Fax back to: 8668804532 The Scott & White Health Plan Pharmacy Department manages the pharmacy drug benefit
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What is non-formulary drug request prior?
Non-formulary drug request prior is a process where a healthcare provider requests approval from a payer or insurance company before prescribing a medication that is not on the formulary list.
Who is required to file non-formulary drug request prior?
Healthcare providers such as doctors, nurses, and pharmacists are required to file non-formulary drug request prior.
How to fill out non-formulary drug request prior?
To fill out a non-formulary drug request prior, healthcare providers need to provide patient information, diagnosis, justification for the non-formulary drug, and any supporting documentation.
What is the purpose of non-formulary drug request prior?
The purpose of non-formulary drug request prior is to ensure that the requested medication is medically necessary and appropriate for the patient before it is prescribed.
What information must be reported on non-formulary drug request prior?
The information that must be reported on a non-formulary drug request prior includes patient demographics, medical history, diagnosis, prescribed medication, dosage, frequency, and duration.
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