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HEALTH PARTNERS MEDICARE PRIOR AUTHORIZATION REQUEST FORMLidoderm (lidocaine patches) Medicare Phone: 2159914300Fax back to: 8663713239Health Partners Plans manages the pharmacy drug benefit for your
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How to fill out lidocaine patches - medicare

01
Start by washing your hands thoroughly with soap and water.
02
Carefully open the lidocaine patch packaging, making sure not to touch the adhesive side of the patch.
03
Choose an area of clean, dry, and intact skin where you want to apply the lidocaine patch. Avoid areas with cuts, abrasions, or rashes.
04
Remove the protective liner from the patch, being careful not to fold or crease it.
05
Gently press the adhesive side of the patch onto the chosen area of skin. Make sure it adheres firmly and lies flat.
06
Wash your hands again to remove any residue that may have transferred during application.
07
Avoid applying excessive pressure or rubbing the patch after application, as this may cause it to come off.
08
Leave the lidocaine patch on for the prescribed length of time. Follow your healthcare provider's instructions regarding duration of use.
09
After the recommended time, carefully remove the patch by peeling it off slowly and uniformly, taking care not to damage your skin.
10
Dispose of the used patch in a manner recommended by your healthcare provider or follow local waste disposal guidelines.
11
Wash your hands again to remove any remaining residue.

Who needs lidocaine patches - medicare?

01
Lidocaine patches may be beneficial for individuals who are experiencing localized pain, such as those with postherpetic neuralgia (pain that occurs after a shingles outbreak), diabetic neuropathy (nerve damage caused by diabetes), or other conditions causing nerve pain.
02
Medicare beneficiaries who are prescribed lidocaine patches by their healthcare provider may be eligible for coverage, depending on their specific Medicare plan and coverage guidelines.
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Lidocaine patches are medicated patches that contain lidocaine, a local anesthetic, used to relieve pain.
Healthcare providers who prescribe or administer lidocaine patches to Medicare patients are required to file the necessary claims.
Healthcare providers can fill out the necessary forms for lidocaine patches through the Medicare billing system or through a third-party billing service.
The purpose of lidocaine patches in Medicare is to provide pain relief for patients who are covered under the Medicare program.
Information such as the patient's Medicare ID, diagnosis, treatment code, and the number of patches used must be reported on the claims for lidocaine patches.
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