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HOME INFUSION/ENTERAL THERAPY AUTHORIZATION FORM Instructions: Please print all requested information and submit this form with physician order to OSU Health Plan via email at: UtilizationManagement.OSUHealthPlan@osumc.edu
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How to fill out home infusionenteral formrapy authorization

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How to fill out home infusionenteral formrapy authorization

01
Contact your healthcare provider to discuss the need for home infusion/enteral therapy.
02
Complete the necessary paperwork provided by your healthcare provider or infusion/enteral therapy provider.
03
Ensure all required information is filled out accurately and completely.
04
Submit the completed form to your healthcare provider for authorization.
05
Wait for approval before starting home infusion/enteral therapy.

Who needs home infusionenteral formrapy authorization?

01
Patients who require infusion or enteral therapy at home and have been prescribed by their healthcare provider.
02
Caregivers or family members who will be overseeing the administration of infusion/enteral therapy at home.
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Home infusion/enteral therapy authorization is the process of obtaining permission to provide and administer specialized medications and nutrition through infusion or enteral methods in a home setting.
Healthcare providers, such as nurses or pharmacists, who are responsible for administering infusion/enteral therapy in a home setting are required to file for authorization.
Home infusion/enteral therapy authorization forms typically require information about the patient, medications or nutrition being administered, dosages, frequency, method of administration, and healthcare provider signatures.
The purpose of home infusion/enteral therapy authorization is to ensure the safe and proper administration of specialized medications and nutrition in a home setting, under the supervision of trained healthcare professionals.
Information such as patient details, medication/nutrition details, dosages, administration methods, healthcare provider information, and signatures are typically required to be reported on home infusion/enteral therapy authorization forms.
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