Get the free Express scripts prior authorization form 2017

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How to fill out express scripts prior authorization

How to fill out express scripts prior authorization:

1. Obtain the necessary prior authorization form from express scripts. This can usually be done online or by contacting their customer service.
2. Fill out your personal information accurately, including your name, date of birth, contact information, and insurance details.
3. Provide the necessary information about the medication for which you are seeking prior authorization. This may include the name of the medication, dosage, frequency, and prescribing physician's information.
4. Clearly state the reason for needing the medication and why it is medically necessary. This may require providing additional supporting documentation such as medical records or test results.
5. If applicable, include any alternative medications that have been tried and failed, along with the reasons for their ineffectiveness or intolerability.
6. Make sure to review the completed form for any errors or missing information before submitting it.
7. Sign and date the form as required.
8. Submit the prior authorization form to express scripts through the designated method, which may include mailing, faxing, or submitting it online through their portal.

Who needs express scripts prior authorization?

1. Patients who are prescribed medications that require prior authorization by their insurance provider.
2. Those who have insurance coverage through express scripts or a plan that utilizes express scripts as their pharmacy benefit manager may need to obtain prior authorization for certain medications.
3. Prior authorization is typically required for medications that are considered non-formulary, costly, or have certain restrictions placed on their use, such as a step therapy protocol.

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What is express scripts prior authorization?

Express Scripts prior authorization is a requirement for certain medications that must be approved by a healthcare payer before a pharmacy can dispense the prescribed medication. It is a process that ensures the medication is medically necessary and appropriate for the patient's condition.

Who is required to file express scripts prior authorization?

Healthcare providers, such as physicians or authorized prescribers, are typically required to file Express Scripts prior authorization requests on behalf of their patients when prescribed medications that fall under this requirement.

How to fill out express scripts prior authorization?

To fill out an Express Scripts prior authorization, the prescriber must complete a form that includes patient information, clinical diagnosis, medication requested, and supporting medical information, including previous treatments and their outcomes, if applicable.

What is the purpose of express scripts prior authorization?

The purpose of Express Scripts prior authorization is to ensure the safe and effective use of medications, control prescription drug costs, and promote appropriate prescribing practices by verifying that the prescribed medication is suitable for the patient.

What information must be reported on express scripts prior authorization?

Information that must be reported on Express Scripts prior authorization includes the patient's name and insurance information, prescriber details, specific medication requested, diagnosis, previous medications tried, and any relevant medical history to justify the need for the requested medication.