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PRIOR AUTHORIZATION FORM NonPreferred NSAIDs Medicaid Unless otherwise indicated below, authorization quantities are limited to the manufacturer recommended dosageComplete online at www.selecthealth.org/pa
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How to fill out non-preferred nsaids - medicaid
How to fill out non-preferred nsaids - medicaid
01
To fill out non-preferred NSAIDs through Medicaid, follow these steps:
02
Check your Medicaid formulary to identify the list of preferred NSAIDs.
03
If the prescribed NSAID is not on the preferred list, it is considered non-preferred.
04
Consult with your healthcare provider about the necessity of the non-preferred NSAID for your condition.
05
Obtain a prior authorization form from your healthcare provider, if required.
06
Complete the prior authorization form accurately and provide all necessary supporting documentation.
07
Submit the prior authorization form to the Medicaid office or the designated entity.
08
Wait for the approval decision from Medicaid.
09
If the prior authorization is approved, you can fill the non-preferred NSAID prescription.
10
Follow any additional instructions provided by Medicaid or your healthcare provider.
11
Keep track of any co-pays or cost-sharing requirements associated with the medication.
Who needs non-preferred nsaids - medicaid?
01
Non-preferred NSAIDs through Medicaid may be required by individuals who:
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- Have a medical condition that specifically requires a non-preferred NSAID as determined by their healthcare provider.
03
- Have unsuccessfully tried preferred NSAIDs or experienced adverse effects from them.
04
- Require a specific brand or formulation of NSAID that falls under the non-preferred category.
05
- Meet the clinical criteria outlined by Medicaid or their state's guidelines for non-preferred NSAID coverage.
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What is non-preferred nsaids - medicaid?
Non-preferred NSAIDs under Medicaid refer to those non-steroidal anti-inflammatory drugs that are not listed as preferred on the Medicaid formulary, often requiring prior authorization before being prescribed.
Who is required to file non-preferred nsaids - medicaid?
Healthcare providers, typically physicians and pharmacists, are required to file claims for non-preferred NSAIDs when prescribed to Medicaid beneficiaries.
How to fill out non-preferred nsaids - medicaid?
To fill out claims for non-preferred NSAIDs under Medicaid, providers must complete the appropriate claim forms detailing the patient's information, the prescribed medication, dosage, and justification for the non-preferred status.
What is the purpose of non-preferred nsaids - medicaid?
The purpose of non-preferred NSAIDs in Medicaid is to manage costs and ensure that alternative preferred medications are considered first before allowing access to more expensive non-preferred options.
What information must be reported on non-preferred nsaids - medicaid?
Required information includes patient identification, prescriber information, medication details, dosage, reason for non-preferred status, and any supporting clinical documentation.
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