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2211 Sanders Road, Northbrook, IL 60062 Phone (866) 8145506Fax Transmittal Fax: Auth.OfficeContactFaxNumber To: Auth.ProviderBilling.Name.Legal From: CVS Fax: (855) 3301720 Re: Prior Authorization
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Obtain a copy of the Riverside Health Formulary.
02
Read through the formulary to understand the information required.
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Fill in each section of the formulary accurately and completely.
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Provide all necessary personal and medical information as requested.
05
Double check your answers to ensure accuracy and completeness.
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Submit the completed formulary as instructed by Riverside Health.

Who needs riverside health formulary?

01
Individuals who are seeking medical care or treatment at Riverside Health facilities.
02
Patients who need to provide comprehensive information about their medical history and current medications.
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The Riverside Health Formulary is a comprehensive list of medications and treatments that are approved for use within the Riverside Health system, aimed at ensuring safe and effective patient care.
Healthcare providers and institutions within the Riverside Health network are required to file the Riverside Health Formulary to ensure compliance with regulatory standards and organizational policies.
To fill out the Riverside Health Formulary, providers must gather patient information, medication details, treatment plans, and complete the designated forms accurately before submitting them through the appropriate channels.
The purpose of the Riverside Health Formulary is to standardize medication use, enhance patient safety, manage costs, and improve the overall quality of care provided within the healthcare system.
The Riverside Health Formulary requires reporting of patient demographics, medical history, prescribed medications, dosage instructions, and any relevant clinical notes.
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