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PRIOR AUTHORIZATION REQUEST FORM EOC ID:SWAP Formulary Drug Request Phone: 8007287947Fax back to: 8668804532The Scott & White Health Plan Pharmacy Department manages the pharmacy drug benefit for
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How to fill out swhp non-formulary drug

01
To fill out the SWHP non-formulary drug request form, follow these steps:
02
Obtain a copy of the SWHP non-formulary drug request form. This can usually be found on the SWHP website or requested from the SWHP customer service.
03
Fill out the patient information section of the form. Provide details such as the patient's name, address, contact information, and insurance information.
04
Provide information about the prescribed non-formulary drug. This includes the drug name, dosage, and frequency of use.
05
Attach any supporting documentation, such as a prescription or a letter of medical necessity, if required.
06
Review the completed form to ensure all information is accurate and complete.
07
Submit the form by either mailing it to the designated address or submitting it online through the SWHP website.
08
Wait for the SWHP to review the request and make a decision. They may contact the patient or healthcare provider for additional information if needed.
09
Once the request is processed, the patient will be notified of the decision. If approved, the non-formulary drug may be covered by the SWHP according to their policies.

Who needs swhp non-formulary drug?

01
SWHP non-formulary drugs are typically needed by individuals who require specific medications that are not included in the SWHP formulary list.
02
Some common reasons why someone may need a non-formulary drug include:
03
- Allergic reactions or adverse effects to medications on the formulary list
04
- Lack of therapeutic alternatives in the formulary list
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- Patients with chronic conditions or complex medical needs
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- Prescribed medications that are not typically covered under the formulary due to cost or other reasons
07
It is important to consult with a healthcare provider or pharmacist to determine if a non-formulary drug is necessary and if it can be requested through SWHP.
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Swhp non-formulary drug is a medication that is not included on the preferred drug list maintained by the Statewide Health Plan.
Healthcare providers and facilities are required to file swhp non-formulary drug when prescribing or administering medications that are not on the preferred drug list.
To fill out swhp non-formulary drug, healthcare providers need to complete a specific form provided by the Statewide Health Plan and submit it according to the instructions provided.
The purpose of swhp non-formulary drug reporting is to track the use of medications not on the preferred drug list and ensure appropriate utilization.
The information that must be reported on swhp non-formulary drug includes the name of the medication, its dosage, the reason for prescribing it, and the patient's information.
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