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Clinical Policy: Everolimus (Finite, Finite Disperse, Fortress)
Reference Number: CP.PAR.63
Effective Date: 06.01.11
Last Review Date: 02.24
Line of Business: Commercial, HIM×, MedicaidCoding Implications
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What is clinical policy non-formulary?
Clinical policy non-formulary refers to medications or treatments that are not included in a specific formulary list, which outlines covered drugs or therapies by an insurance plan or healthcare provider.
Who is required to file clinical policy non-formulary?
Healthcare providers, including physicians, and sometimes administrative staff, are typically required to file clinical policy non-formulary requests, especially when prescribing treatments outside the formulary.
How to fill out clinical policy non-formulary?
To fill out a clinical policy non-formulary request, one must collect necessary documentation, provide patient information, specify the requested drug or treatment, justify the need for non-formulary usage, and submit the form to the appropriate department or an insurer.
What is the purpose of clinical policy non-formulary?
The purpose of clinical policy non-formulary is to ensure that the use of non-formulary medications is justified and monitored, allowing for exceptions when necessary for patient care.
What information must be reported on clinical policy non-formulary?
Information required typically includes patient demographics, clinical justification for the non-formulary medication, details of previous treatments, and any supporting clinical evidence.
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