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DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F00401A (01/2020)STATE OF WISCONSIN Wis. Admin. Code DHS 107.10FORWARDHEALTHPRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR EXPEDITED
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How to fill out prior authorizationpreferred drug list

01
To fill out a prior authorization preferred drug list, follow these steps:
02
Obtain the preferred drug list form from your healthcare provider or insurance company.
03
Read the instructions on the form carefully to understand the requirements and guidelines.
04
Gather all the necessary information about your prescription medications, including the name, dosage, and quantity.
05
Review the preferred drug list to identify if any of your current medications are listed as preferred or require prior authorization.
06
If your medication is listed as preferred, simply mark it on the form.
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If your medication requires prior authorization, provide the additional information requested on the form, such as medical justification, diagnosis, and prescribing physician details.
08
Double-check your completed form for accuracy and completeness.
09
Submit the filled-out prior authorization preferred drug list form to your healthcare provider or insurance company as instructed.
10
Wait for a response from your healthcare provider or insurance company regarding approval or denial of your requested medications.
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If approved, you can proceed to obtain your preferred medications. If denied, follow up with your healthcare provider or insurance company for further instructions or alternatives.

Who needs prior authorizationpreferred drug list?

01
Prior authorization preferred drug lists are typically needed by individuals with health insurance coverage that requires prior approval for certain medications.
02
The specific criteria for who needs prior authorization and which medications require it may vary depending on the insurance plan or healthcare provider's policies.
03
It is recommended to consult your healthcare provider or insurance company to determine if you require prior authorization for certain prescription medications and to obtain the prior authorization preferred drug list.
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A prior authorization preferred drug list is a list of medications that require approval from a health insurer before they are covered under a healthcare plan. This process aims to ensure that the prescribed medication is necessary and appropriate for the patient's condition.
Healthcare providers, such as doctors or pharmacists, are typically required to file for prior authorization on behalf of the patient to obtain coverage for non-preferred medications.
To fill out the prior authorization preferred drug list, healthcare providers need to complete a form that usually includes the patient's personal information, diagnosis, medication details, and justification for the prescribed drug.
The purpose of the prior authorization preferred drug list is to manage costs by requiring approval for certain medications, ensuring that patients receive appropriate and effective treatments based on clinical guidelines.
Information typically required includes the patient's demographic details, the prescribed medication, diagnosis, previous treatment history, and clinical rationale for the medication.
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