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Get the free Pharmacy External Review Request Form - doi sc

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South Carolina Department of Insurance 1201 Main Street, Suite 1000 Columbia, SC 29201 Office of PBM OversightP.O. Box 100105, Columbia, SC 292023105 Telephone: (803) 7340398Pharmacy External Review
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Pharmacy external review request allows pharmacies to request an independent review of a decision made by a health plan or insurance company regarding coverage of a particular medication or service.
Pharmacies or pharmacists who believe that a decision made by a health plan or insurance company regarding coverage of a medication or service is incorrect or unfair are required to file a pharmacy external review request.
Pharmacy external review requests can typically be filled out online through the health plan or insurance company's website, or by contacting their customer service department.
The purpose of pharmacy external review request is to provide pharmacies with an opportunity to challenge and potentially overturn decisions made by health plans or insurance companies regarding coverage of medications or services.
Pharmacy external review requests typically require information such as the medication or service in question, the reasons for challenging the decision, and any supporting documentation.
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