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HEALTH PARTNERS PLANS PRIOR AUTHORIZATION REQUEST FORMColony Stimulating Factors Phone: 2159914300Fax back to: 8662403712Health Partners Plans manages the pharmacy drug benefit for your patient. Certain
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Check the prescription for the specific type and amount of colony stimulating factor needed.
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Who needs colony stimulating factors?
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Patients undergoing chemotherapy to help boost their immune system and increase white blood cell production.
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Patients with certain blood disorders such as neutropenia or anemia may also benefit from colony stimulating factors.
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Individuals with compromised immune systems due to conditions like HIV/AIDS or post-transplant may require colony stimulating factors to help increase their white blood cell count.
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What is colony stimulating factors?
Colony stimulating factors are proteins that regulate the growth, differentiation, and function of cells in the immune system.
Who is required to file colony stimulating factors?
Hospitals and healthcare providers who administer colony stimulating factors to patients are required to file.
How to fill out colony stimulating factors?
Colony stimulating factors should be filled out with all necessary information, including patient details, dosage administered, and any side effects observed.
What is the purpose of colony stimulating factors?
The purpose of colony stimulating factors is to stimulate the production of white blood cells in patients who have weakened immune systems.
What information must be reported on colony stimulating factors?
Information such as patient name, date of administration, dosage, and any adverse reactions must be reported on colony stimulating factors.
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