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MICHIGAN Department Of Community Health Pharmacy Program Prior Authorization Request ADD/ADHD Therapy For Recipients Over Age 17 Years All information addressed on this form must be provided for consideration
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Point by point steps on how to fill out incomplete requests will not:

01
Gather all necessary information: Before starting to fill out the request, make sure you have all the required information at hand. This may include personal details, relevant documents, or any specific instructions mentioned in the request.
02
Understand the purpose of the request: Take the time to understand why the request was made and what it is aiming to achieve. This will help you provide the appropriate information and fulfill the requirements effectively.
03
Identify the missing information: Review the incomplete parts of the request and determine what specific information is missing. It could be an address, a date, a signature, or any other relevant details.
04
Communicate with the requester: If possible, reach out to the requester or the party responsible for the request to clarify the missing information. This could be done through email, phone call, or in-person communication, depending on the nature of the request.
05
Seek guidance or assistance, if necessary: If you are unsure about how to proceed or if the missing information is not easily attainable, seek guidance or assistance from appropriate sources. This could be a supervisor, a colleague, or an expert in the field who can provide valuable insights or suggestions.
06
Fill out the available information accurately: Complete the parts of the request that you are able to without the missing information. Ensure that the provided details are accurate and in line with the purpose of the request.
07
Make a note of the incomplete parts: Clearly indicate the parts of the request that are not filled out due to missing information. Use a highlighter, asterisk, or any other method to make it evident that those parts are pending completion.
08
Provide an explanation, if required: If the missing information is crucial and you are unable to obtain it, provide an explanation in the request form or accompanying documentation. Explain the efforts made to acquire the missing information and any constraints preventing its inclusion.
09
Submit the completed parts: Once all available information is provided and any necessary explanations are given, submit the filled-out parts of the request as per the submission instructions mentioned.

Who needs incomplete requests will not:

01
Individuals needing accurate information: Incomplete requests will not be beneficial for individuals or entities who require complete and accurate information to fulfill a task, make a decision, or meet specific requirements.
02
Organizations with strict compliance standards: Organizations that adhere to strict compliance regulations and guidelines often cannot accept incomplete requests. Complete and accurate information is necessary to ensure compliance and avoid legal or operational issues.
03
Request evaluators or processors: Professionals responsible for evaluating or processing requests rely on complete information to make informed decisions. Incomplete requests can hinder their ability to assess the situation effectively, leading to delays or incorrect outcomes.
04
Entities affected by the request outcome: Any individual or organization affected by the outcome of the request might not find incomplete requests helpful. They rely on comprehensive information to understand the situation, assess potential impacts, and take necessary actions.
Overall, incomplete requests will not be useful for those who value thoroughness, accuracy, compliance, and effective decision-making based on complete information.
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