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Please complete ALL information below and fax your request to 18886715285Flector (diclofenac examine patch) & 2% Prior Authorization Request Form DO NOT COPY FOR FUTURE USE. FORMS ARE UPDATED FREQUENTLY
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What is diclofenac sodium prior authorization?
Diclofenac sodium prior authorization is a process where a healthcare provider must obtain approval from the insurance company before prescribing diclofenac sodium to a patient.
Who is required to file diclofenac sodium prior authorization?
Healthcare providers, such as doctors and pharmacists, are required to file diclofenac sodium prior authorization.
How to fill out diclofenac sodium prior authorization?
To fill out diclofenac sodium prior authorization, healthcare providers need to submit the necessary information about the patient's condition, medical history, and the reason for prescribing diclofenac sodium.
What is the purpose of diclofenac sodium prior authorization?
The purpose of diclofenac sodium prior authorization is to ensure that the medication is being used appropriately and to control costs for the insurance company.
What information must be reported on diclofenac sodium prior authorization?
Information such as the patient's diagnosis, previous treatments, current medications, and the healthcare provider's rationale for prescribing diclofenac sodium must be reported on the prior authorization form.
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