Get the free Olumiant (baricitinib) Medication Precertification Request. Olumiant (baricitinib) M...

Claimant (baricitinib) Medication Recertification RequestAetna Recertification Notification 503 Support Lane, Orlando, FL 32809 Phone: 18665030857 FAX: 18882673277Page 1 of 2 (All fields must be completed

How to fill out olumiant baricitinib medication precertification

How to fill out olumiant baricitinib medication precertification

1. To fill out the Olumiant Baricitinib medication precertification form, follow the steps below:
2. Obtain the form: Contact your healthcare provider or insurance company to request the Olumiant Baricitinib medication precertification form.
3. Read the instructions: Carefully review the instructions provided with the form. It will provide important information on how to properly fill out the form.
4. Provide personal information: Fill in your personal details such as name, date of birth, address, and contact information.
5. Medical history: Provide information about your medical history, including any current conditions, medications, and previous treatments.
6. Prescribing physician information: Enter the details of the physician who has prescribed Olumiant Baricitinib to you.
7. Insurance information: Include your insurance details, such as policy number, group number, and contact information.
8. Supporting documents: Attach any required supporting documents, such as medical reports or physician's notes.
9. Review and submit: Double-check all the information provided on the form to ensure accuracy. Sign and date the form, then submit it to the designated address or fax number.
10. Follow up: Contact your healthcare provider or insurance company to confirm receipt of the precertification form. Inquire about the processing time and any additional steps required.
11. Note: The specific instructions and requirements may vary depending on your healthcare provider and insurance company. It's always best to consult the provided instructions or seek assistance if needed.

Who needs olumiant baricitinib medication precertification?

1. Olumiant Baricitinib medication precertification is typically required for individuals who meet certain criteria set by their healthcare provider or insurance company. The specific criteria may vary, but generally, the following individuals may need precertification:
2. - Patients with rheumatoid arthritis who have been prescribed Olumiant Baricitinib as part of their treatment plan.
3. - Patients with moderate to severe active rheumatoid arthritis who have not responded adequately to other medications or therapies.
4. - Patients who require continued access to Olumiant Baricitinib beyond the initial prescription period.
5. It is important to note that eligibility for precertification may also depend on the specific insurance plan and coverage policy. It is recommended to consult with your healthcare provider or insurance company for detailed information about precertification requirements and eligibility.

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