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HEALTH PARTNERS PLANS PRIOR AUTHORIZATION REQUEST FORMBenzodiazepine with Phone: 2159914300Fax back to: 8662403712Health Partners Plans manages the pharmacy drug benefit for your patient. Certain
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Benzodiazepine is a type of psychoactive drug used to treat conditions like anxiety, insomnia, and seizures.
Healthcare professionals and pharmacies are required to file benzodiazepine prescriptions with the appropriate regulatory bodies.
Benzodiazepine prescriptions should be filled out with the patient's information, the prescriber's information, the type and dosage of the medication, and the date of the prescription.
The purpose of filing benzodiazepine prescriptions is to monitor the use of these controlled substances and prevent misuse or abuse.
The information reported on a benzodiazepine prescription includes the patient's name, date of birth, address, prescriber's name, medication name, dosage, quantity, and refills.
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