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UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number Program Medication P&T Approval Date Effective Date2017 P 12032 Prior Authorization/Formulary Teresina (insulin deluded) 11/2016,

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What is prior authorizationnon-formulary?

Prior authorizationnon-formulary is a process where approval is required from the insurance company before a medication can be covered when it is not on the formulary.

Who is required to file prior authorizationnon-formulary?

Healthcare providers or pharmacists are usually required to file for prior authorizationnon-formulary.

How to fill out prior authorizationnon-formulary?

To fill out prior authorizationnon-formulary, healthcare providers need to complete a form detailing the medical necessity of the non-formulary medication.

What is the purpose of prior authorizationnon-formulary?

The purpose of prior authorizationnon-formulary is to ensure that non-formulary medications are medically necessary and to control costs for insurance companies.

What information must be reported on prior authorizationnon-formulary?

Information such as patient demographics, medical history, diagnosis, and requested medication details must be reported on prior authorizationnon-formulary.

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