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Prior authorization is a time-consuming, labor-intensive, and often frustrating process. Requests require several steps, and theres often a lot of back and forth with payers, especially if the initial request isnt accurate and complete.
How to do a prior authorization for medication?
Prior authorization denials create just one more barrier between patients and the medication they have been prescribed. Simple errors such as leaving fields blank, misspellings or failure to follow payer requirements are common reasons for denials that can be reduced with electronic prior authorization (ePA) solutions.
What is needed for a prior authorization for medication?
If your provider submits the request, they will send the required information to your health plan. You may need to fill out forms for your providers office. A prior authorization form will include information about you, your medical conditions, and your health care needs.
Why is it so hard to get a prior authorization?
Can doctors charge for prior authorizations? Physicians and other healthcare providers do not usually charge for prior authorizations. Even if they wanted to, most contracts between providers and payers forbid such practices.
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Drug Prior Approval requests may be submitted using the following methods: NCPDP D. Fax to the Drug Prior Approval Hotline at 217-524-7264 or 217-524-0404.
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