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Right way Phone: 888.665.1885 Fax: 888.498.1038 GENERAL AUTHORIZATION FORM Prior Authorization, Step Therapy & Quantity Limit Exception Standard Request Expedited Request you or your prescriber
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How to fill out prior authorization and step

01
Obtain the prior authorization form from the insurance company or download it from their website.
02
Fill out all required fields on the form including patient information, provider information, diagnosis codes, procedure codes, and any supporting documentation.
03
Clearly explain the medical necessity for the requested treatment or service.
04
Submit the completed form and supporting documents to the insurance company either electronically or via mail.
05
Follow up with the insurance company to ensure the prior authorization request is processed in a timely manner.

Who needs prior authorization and step?

01
Prior authorization is typically required for certain medical procedures, treatments, medications, or services that are considered to be non-emergent or elective.
02
Healthcare providers, hospitals, clinics, and patients may need to obtain prior authorization from insurance companies before proceeding with the recommended treatment or service.
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Prior authorization is the process used by health insurers to determine if they will cover a prescribed procedure, service, or medication before it is done. Step therapy is a requirement for patients to try one or more similar, lower-cost medications before the insurer will cover the prescribed medication.
Healthcare providers are typically required to file prior authorization and step for their patients.
Healthcare providers must submit the necessary forms and documentation to the insurance company, detailing the medical necessity of the prescribed treatment.
The purpose of prior authorization and step is to ensure cost-effective healthcare by requiring patients to try lower-cost alternatives before accessing more expensive treatments.
Information such as patient medical history, diagnosis, prescribed treatment, and reasoning for the prescribed treatment must be reported on prior authorization and step forms.
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