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DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Medicaid Services Wis. Admin. Code DHS 107.10(2) F11092 (07/2024)FORWARDHEALTH PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL)FOR DRUGSINSTRUCTIONS:

How to fill out prior authorization preferred drug

How to fill out prior authorization preferred drug

1. Obtain the prior authorization form from the insurance company or pharmacy.
2. Provide all necessary information about the patient including name, date of birth, and insurance ID number.
3. Include the prescribing doctor's information such as name, contact details, and NPI number.
4. Specify the preferred drug that requires prior authorization and the reason for requesting it.
5. Submit the completed form to the insurance company for review and approval.
6. Follow up with the insurance company to ensure that the prior authorization has been processed successfully.

Who needs prior authorization preferred drug?

1. Patients who are prescribed a preferred drug that requires prior authorization from their insurance company.
2. Pharmacists who need to assist patients in completing the prior authorization process.
3. Healthcare providers who are prescribing medications that are not on the patient's insurance formulary.

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What is prior authorization preferred drug?

A prior authorization preferred drug is a medication that requires approval from an insurance provider before it can be prescribed, ensuring it meets specific criteria for coverage.

Who is required to file prior authorization preferred drug?

Healthcare providers or prescribers are typically required to file prior authorization for preferred drugs on behalf of the patient.

How to fill out prior authorization preferred drug?

To fill out a prior authorization, a provider must complete a specific form detailing the patient's medical history, the prescribed medication, and justification for its necessity.

What is the purpose of prior authorization preferred drug?

The purpose of prior authorization preferred drug is to control costs and ensure that patients receive appropriate medications that are medically necessary.

What information must be reported on prior authorization preferred drug?

Information that must be reported includes patient demographics, medication details, diagnosis, treatment history, and any relevant clinical information supporting the request.