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DEPARTMENT OF HEALTH SERVICES Division of Health Care Access and Accountability F-00280 (07/13) STATE OF WISCONSIN DHS 107.10(2), Wis. Admin. Code FORWARDHEALTH PRIOR AUTHORIZATION / PREFERRED DRUG

How to fill out prior authorization preferred drug

How to fill out prior authorization preferred drug:

1. Start by gathering all necessary information: Before filling out the prior authorization form for a preferred drug, you will need to have certain information at hand. This may include the patient's personal details, such as their name, date of birth, and insurance information. Additionally, you will need to know the specific drug being requested and the medical condition for which it is being prescribed.
2. Obtain the prior authorization form: Contact the patient's insurance provider to obtain the prior authorization form for the preferred drug. This form may be available online through the insurance company's website or can be requested by phone or email. Make sure to obtain the most current version of the form.
3. Review the instructions: Carefully read through the instructions provided on the prior authorization form. These instructions will guide you on how to accurately fill out the form and what supporting documentation might be required.
4. Complete the patient information section: Begin filling out the form by providing the patient's details in the designated section. This typically includes their name, address, phone number, date of birth, insurance ID number, and any other relevant information.
5. Provide the prescriber's details: In the appropriate section of the form, enter the name, address, phone number, and other necessary information of the healthcare provider who prescribed the preferred drug.
6. Fill in the drug information: Specify the preferred drug being requested by entering its brand name, generic name (if applicable), dosage strength, quantity, and any other relevant details. You may need to attach a copy of the prescription or the medication's bottle label as proof.
7. Include supporting documentation: Some insurance companies may require additional supporting documentation, such as medical records or clinical notes, to justify the need for the preferred drug. Ensure that you have all the necessary documents and attach them to the prior authorization form as instructed.
8. Submit the form: Once you have completed the prior authorization form and gathered all required documentation, submit the form to the designated healthcare provider or insurance company. This can usually be done electronically, by mail, or through fax. Keep a copy of the filled-out form and any accompanying documents for your records.

Who needs prior authorization preferred drug:

1. Patients with insurance coverage: Prior authorization for a preferred drug is typically required for patients who have insurance coverage. Insurance companies impose prior authorization to ensure that the prescribed medication is medically necessary and cost-effective.
2. Healthcare providers prescribing preferred drugs: Healthcare providers, including doctors, nurse practitioners, and physician assistants, need to obtain prior authorization for prescribing a preferred drug if it is not part of the insurance company's formulary.
3. Patients with specific medical conditions: Prior authorization for a preferred drug may be necessary for patients with specific medical conditions that require the use of a particular medication. Insurance companies often have a list of preferred drugs for various health conditions, and if the prescribed drug falls outside of this list, prior authorization may be required.

For pdfFiller’s FAQs

What is prior authorization preferred drug?

Prior authorization preferred drug is a specific list of medications that require approval from a health insurance provider before they will cover the cost.

Who is required to file prior authorization preferred drug?

Healthcare providers are typically responsible for filing prior authorization requests for preferred drugs.

How to fill out prior authorization preferred drug?

To fill out a prior authorization for a preferred drug, healthcare providers must provide specific information about the patient, diagnosis, and medication.

What is the purpose of prior authorization preferred drug?

The purpose of prior authorization for preferred drugs is to ensure appropriate and cost-effective use of medications.

What information must be reported on prior authorization preferred drug?

Information required on a prior authorization for preferred drugs typically includes patient demographics, diagnosis, medication name and strength, and prescriber information.

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