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Prior Authorization Request Form
Fax Back To: (866) 9407328
Phone: (800) 3106826
Specialty Medication Prior Authorization Cover Sheet
(This cover sheet should be submitted along with a Pharmacy Prior
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What is washington community plan pharmacy?
The Washington community plan pharmacy is a program that provides pharmacy services to residents in the Washington community.
Who is required to file washington community plan pharmacy?
Pharmacies that are part of the community plan in Washington are required to file the necessary reports.
How to fill out washington community plan pharmacy?
To fill out the Washington community plan pharmacy, pharmacies must include all required information and submit it by the deadline.
What is the purpose of washington community plan pharmacy?
The purpose of the Washington community plan pharmacy is to ensure that residents have access to necessary pharmacy services.
What information must be reported on washington community plan pharmacy?
Pharmacies must report information on the number of prescriptions filled, services provided, and any other pertinent details.
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