Get the free 002 Mandatory Generic Substitution

PRIOR AUTHORIZATION REQUEST FORM BMCHP 9. 002 Mandatory Generic Substitution BMCHP Mandatory Generic Substitution Program Version 11. Please note any information left blank or illegible may delay the review process. Patient Name Prescriber Name Member/Subscriber Number Fax Date of Birth Office Contact Group Number NPI Address City State ZIP Primary Phone Specialty/facility name if applicable Phone State Lic ID Expedited/Urgent Drug Name and Strength Directions / SIG Please attach any...

How to fill out 002 mandatory generic substitution

How to fill out 002 mandatory generic substitution

1. Step 1: Obtain the 002 mandatory generic substitution form from your pharmacist.
2. Step 2: Read the instructions on the form carefully to understand the requirements.
3. Step 3: Fill in your personal details such as your name, address, and contact information.
4. Step 4: Provide information about the medication that requires substitution, including the brand name and generic name.
5. Step 5: Indicate the reason for requesting the substitution and any relevant medical history.
6. Step 6: Sign and date the form to certify its accuracy.
7. Step 7: Submit the completed form to your pharmacist and keep a copy for your records.

Who needs 002 mandatory generic substitution?

1. Patients who prefer to use generic versions of medications instead of brand-name drugs.
2. Patients who have been recommended generic substitutions by their healthcare provider.
3. Patients who have specific insurance or healthcare coverage that requires the use of generic drugs.
4. Patients who want to save on medication costs by opting for generic alternatives.

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What is 002 mandatory generic substitution?

002 mandatory generic substitution is a regulation that requires pharmacists to automatically substitute a brand-name drug with a generic equivalent, unless specified by the physician or the patient.

Who is required to file 002 mandatory generic substitution?

Pharmacists are required to file 002 mandatory generic substitution.

How to fill out 002 mandatory generic substitution?

To fill out 002 mandatory generic substitution, pharmacists must document the substitution of a brand-name drug with a generic equivalent and keep proper records.

What is the purpose of 002 mandatory generic substitution?

The purpose of 002 mandatory generic substitution is to promote cost savings and increase access to affordable medications.

What information must be reported on 002 mandatory generic substitution?

The information reported on 002 mandatory generic substitution includes the brand-name drug being substituted, the generic equivalent, and any relevant patient information.