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DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F11092 (07/2020)STATE OF WISCONSIN Wis. Admin. Code DHS 107.10(2)FORWARDHEALTHPRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR DRUGS

How to fill out prior authorizationpreferred drug list

How to fill out prior authorizationpreferred drug list

1. Obtain a prior authorization form from your insurance provider or pharmacy.
2. Fill out your personal information, including name, address, and insurance ID number.
3. Provide information about the medication you are requesting, including name, dosage, and frequency.
4. Have your healthcare provider complete any necessary sections of the form, including diagnosis and reason for the request.
5. Submit the completed form to your insurance provider or pharmacy for review.

Who needs prior authorizationpreferred drug list?

1. Patients who are prescribed a medication that is not on their insurance provider's preferred drug list.

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What is prior authorization preferred drug list?

A prior authorization preferred drug list is a list of medications that require approval from a health insurance provider before being dispensed to ensure they are medically necessary and meet specific criteria.

Who is required to file prior authorization preferred drug list?

Healthcare providers and pharmacies are typically required to file a prior authorization preferred drug list when prescribing or dispensing medications that are not on the insurance plan's formulary.

How to fill out prior authorization preferred drug list?

To fill out a prior authorization preferred drug list, healthcare providers should complete the necessary forms provided by the insurance company, including patient information, medication details, and justification for the requested medication.

What is the purpose of prior authorization preferred drug list?

The purpose of a prior authorization preferred drug list is to manage medication costs, ensure appropriate medication use, and promote the use of effective and safe treatments.

What information must be reported on prior authorization preferred drug list?

Information that must be reported typically includes patient demographics, prescribing physician details, medication requested, diagnosis, and clinical rationale for the medication.