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Get the free Drug Exception PA FormMagellan Rx Management. Drug Exception

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Reset Footprint Imprecision Formulary Exclusion Exception Request Form Fax this form to: 18004243260 A fax cover sheet is not required. Instructions: Please fill out all applicable sections on all
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The drug exception PA (Prior Authorization) form for Magellan is a document used to request permission from Magellan, a pharmacy benefit manager, to prescribe a medication that requires prior authorization before being covered by insurance.
Healthcare providers or prescribers who wish to obtain approval for medications that are not covered without prior authorization are required to file the drug exception PA form with Magellan.
To fill out the drug exception PA form for Magellan, a healthcare provider should provide patient information, details about the medication being requested, the diagnosis, treatment history, and any supporting documentation required to justify the exception.
The purpose of the drug exception PA form for Magellan is to evaluate requests for coverage of medications that fall outside standard insurance policies, ensuring they are medically necessary for the patient.
The information that must be reported includes the patient’s name, insurance details, medication name and dosage, diagnosis, prior medications attempted, and documentation supporting the medical necessity of the requested drug.
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