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Express scripts tier exception form 2022 PDF 4.9 Stars | 29 Ratings 1,252 Downloads Updated June 08, 2022An Express Scripts prior authorization form is meant to be used by medical offices when requesting

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How to fill out express scripts tier exception

01

Access the Express Scripts website or contact customer service to request a tier exception form.

02

Fill out the form completely, providing all necessary information such as your personal details, prescription information, and reasons for requesting the tier exception.

03

Submit the completed form to Express Scripts through the website or by mail, along with any supporting documentation that may be required.

Who needs express scripts tier exception?

01

Individuals who have a prescription for a medication that is not covered under their current tier on the Express Scripts formulary may need to request a tier exception in order to have the medication covered at a lower cost.

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What is express scripts tier exception?

Express Scripts tier exception is a request for coverage of a medication that is not included in the standard formulary.

Who is required to file express scripts tier exception?

Patients or their healthcare providers may file an express scripts tier exception.

How to fill out express scripts tier exception?

To fill out an express scripts tier exception, one must provide information about the medication, the reason for the request, and any supporting documentation.

What is the purpose of express scripts tier exception?

The purpose of express scripts tier exception is to request coverage for a medication that is not on the standard formulary.

What information must be reported on express scripts tier exception?

Information required on an express scripts tier exception includes details about the medication, reason for request, and any supporting documentation.

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