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Express Scripts Prior Authorization Fax Form PDF Document Prior authorization form general request express scripts this fax form is based on express scripts standard Prior authorization request form

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How to fill out express scripts prior authorization

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Step 1: Gather all necessary information and documents required for express scripts prior authorization.

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Step 2: Review the express scripts prior authorization form and fill in your personal and prescription details.

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Step 3: Attach any supporting documents or medical records requested by express scripts.

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Step 4: Submit the completed express scripts prior authorization form along with any supporting documents via fax, mail, or electronically.

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Step 5: Wait for a response from express scripts regarding the status of your prior authorization request.

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Step 6: If approved, follow the instructions provided by express scripts to obtain your prescribed medication. If denied, you may explore alternative options or contact your healthcare provider for further assistance.

Who needs express scripts prior authorization?

01

Patients who have insurance plans that require prior authorization for certain medications.

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Individuals who are prescribed medications that fall under the prior authorization criteria set by express scripts.

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Healthcare providers who need to obtain approval from express scripts for their patients' prescribed medications.

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