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HEALTH PARTNERS PLANS PRIOR AUTHORIZATION REQUEST FORMBuprenorphine Med Assisted Treatment Renewal Phone: 2159914300Fax back to: 8662403712Health Partners Plans manages the pharmacy drug benefit for
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To fill out med assisted treatment, follow these steps:
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Gather all necessary information and documents such as medical history, prescriptions, and personal identification.
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Contact a healthcare provider or treatment center that offers med assisted treatment.
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Schedule an appointment with a healthcare provider specializing in med assisted treatment.
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Arrive at the scheduled appointment on time and be prepared to discuss your medical history and current condition.
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Answer all questions asked by the healthcare provider regarding your substance use, health, and any medications you are currently taking.
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Follow the instructions provided by the healthcare provider for taking the prescribed medications.
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Attend all follow-up appointments as scheduled and provide updates on your progress and any concerns or side effects you may be experiencing.

Who needs med assisted treatment?

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Med assisted treatment may be suitable for individuals who meet the following criteria:
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- Individuals suffering from opioid use disorder
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- Individuals who have a history of substance abuse or addiction
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- Those who have tried other forms of treatment for substance use disorders without success
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- Individuals who are motivated and committed to their recovery journey
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- Individuals who are willing to follow the prescribed treatment plan and attend the necessary appointments
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- Patients who have been evaluated and recommended for med assisted treatment by a qualified healthcare professional
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Medically assisted treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to provide a holistic approach to the treatment of substance use disorders.
Healthcare providers who are authorized to prescribe medications for substance use disorders are required to file med assisted treatment.
To fill out med assisted treatment, healthcare providers must document the patient's medical history, current medications, treatment plan, and progress notes.
The purpose of med assisted treatment is to help individuals reduce or quit substance use while managing withdrawal symptoms and cravings.
The information that must be reported on med assisted treatment includes the dosage and frequency of medications, any adverse reactions or side effects, and the patient's progress in treatment.
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