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Prior Authorization Former FEDERAL STANDARD OPTION Apex icon E (APA) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign and date.

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Consult with a healthcare provider to determine if a non-preferred high potency group is necessary

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Individuals who require a higher concentration of a medication due to factors such as body weight, severity of illness, or previous treatment failures with lower potency options

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What is non-preferred high potency groups?

Non-preferred high potency groups refer to categories of drugs or treatments that are not generally favored by insurance plans or health maintenance organizations due to their high costs or potential alternatives that are more cost-effective.

Who is required to file non-preferred high potency groups?

Entities such as healthcare providers, pharmacies, and insurance companies that manage or reimburse for medications in these high potency categories are typically required to file non-preferred high potency groups.

How to fill out non-preferred high potency groups?

To fill out non-preferred high potency groups, entities must accurately complete the designated forms provided by the governing health authority, ensuring all required fields are filled in accordance with specified guidelines.

What is the purpose of non-preferred high potency groups?

The purpose of non-preferred high potency groups is to manage healthcare costs and ensure that patients have access to the most effective and economical treatment options, while also monitoring the use of high-cost medications.

What information must be reported on non-preferred high potency groups?

The information that must be reported typically includes the name of the drug, patient information, prescribing physician details, dosage, frequency of administration, and reasons for classification as non-preferred.

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