MEDICATION PERMISSION FORM 2025

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Instructions: This form is to be used by participating physicians and providers to obtain coverage for a formulary drug requiring prior authorization (PA), a non-formulary drug for which there is no suitable alternative available, or any overrides of pharmacy management procedures such as step therapy, quantity limit
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.
The Medication Purpose Form (attached-originally developed by Office of Senior Practitioner, Victoria and Centre for Developmental Disability Health Victoria) is to assist medical practitioners to communicate with disability support staff regarding the purpose of medication prescribed to people with a disability.
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.
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.
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A Medication Authorisation Form is to be completed in full on the first occasion an individual requires support with medication administration as part of a home care package. In the event a service user transfers to a new provider, the original Form remains valid.

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