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Berliner
Prior Authorization Request
Send completed form to: Case Review Unit, CVS Earmark Prior Authorization Fax: 18662496155
CVS Earmark administers the prescription benefit plan for the member
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What is prior authorization request?
A prior authorization request is a process used by healthcare providers to obtain approval from insurance companies or payers before certain medical services or medications can be provided.
Who is required to file prior authorization request?
Healthcare providers such as doctors, hospitals, and pharmacies are required to file prior authorization requests.
How to fill out prior authorization request?
Prior authorization requests are typically filled out by healthcare providers with specific information about the patient, the requested service or medication, and the medical necessity for the treatment.
What is the purpose of prior authorization request?
The purpose of a prior authorization request is to ensure that certain medical services or medications meet the criteria established by insurance companies or payers before providing coverage.
What information must be reported on prior authorization request?
Prior authorization requests typically require information such as patient demographics, medical history, diagnosis codes, procedure codes, and supporting medical documentation.
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