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GLUCOSE TEST STRIPS
PRIOR AUTHORIZATION REQUEST
PRESCRIBER FAX FORM
ONLY the prescriber may complete this form. This form is for prospective, concurrent, and retrospective reviews.
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How to fill out non-preferred glucose test strips

How to fill out non-preferred glucose test strips
01
Step 1: Start by washing your hands thoroughly with soap and water.
02
Step 2: Open the test strip container and ensure that the strips are within their expiration date.
03
Step 3: Take a test strip and insert it into the glucose meter according to the manufacturer's instructions.
04
Step 4: Use a lancet device to prick the side of your fingertip to obtain a small drop of blood.
05
Step 5: Place the drop of blood onto the designated area of the test strip.
06
Step 6: Wait for the glucose meter to display your blood glucose level.
07
Step 7: Record your blood glucose reading and dispose of the used test strip properly.
08
Step 8: Repeat the process as recommended by your healthcare provider.
Who needs non-preferred glucose test strips?
01
Non-preferred glucose test strips are typically recommended for individuals who have diabetes and need to monitor their blood glucose levels regularly.
02
These individuals may include those who are not covered by insurance or those who prefer to use a different brand or type of test strips.
03
It is always best to consult with a healthcare professional to determine if non-preferred test strips are suitable for your specific needs.
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What is non-preferred glucose test strips?
Non-preferred glucose test strips refer to glucose monitoring devices that are not covered or reimbursed by certain health insurance plans or providers, often due to not meeting specific criteria.
Who is required to file non-preferred glucose test strips?
Individuals who use non-preferred glucose test strips may need to file claims with their insurance companies to seek reimbursement, as well as healthcare providers who provide these products.
How to fill out non-preferred glucose test strips?
To fill out non-preferred glucose test strips, individuals must provide details such as patient information, the supplier's information, the product details, and any necessary codes specified by the insurance company.
What is the purpose of non-preferred glucose test strips?
The purpose of non-preferred glucose test strips is to allow individuals with diabetes to monitor their blood glucose levels, even if the strips may not be covered by insurance.
What information must be reported on non-preferred glucose test strips?
Information that must be reported includes the product name, quantity, date of purchase, doctor's prescription (if any), and patient's insurance details.
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