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The document is a Physician Prior Authorization Request Form for specific medications (Naprelan, Pennsaid, Sprix, Zipsor, Zorvolex) used by BlueChoice® HealthPlan. It collects patient and provider information and includes a series of questions to determine the necessity of the requested drug based on FDA approval, previous treatment failures with generic NSAIDs, contraindications, adverse reactions, and adherence to dosing guidelines. The form must be faxed to Caremark for processing.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I submit a formulary exception?

Your doctor is your ally on this. Most plans require that your doctor submit a formulary exception on your behalf. The doctor will need to send paperwork to your health plan indicating the reason that you cant take the preferred medications and must have one that is not currently on the formulary.

What triggers a prior authorization?

Prior authorizations are usually only required for more costly, involved treatments where an alternative is available. For instance, if a physician prescribes an invasive procedure such as orthopedic surgery, it will likely require preauthorization.

Can I get a prescription without prior authorization?

Prior authorization is usually required if you need a complex treatment or prescription. Coverage will not happen without it.

Can I get my medication without prior authorization?

Prior authorization requires your doctor or provider to obtain approval from your health plan before providing health care services or prescribing prescription drugs. Without prior authorization, your health plan may not pay for your treatment or medication. (Emergency care doesnt need prior authorization.)

What are prior authorization and the formulary exception process?

What Are Prior Authorization and the Formulary Exception Process? The term prior authorization may also refer to a commonly used managed care strategy called the formulary exception process, which allows exceptions to a plans formulary (see A M C P s Concept Series paper, Form u l a ry Management).

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Why is prior authorization necessary?

Prior authorization (PA) is an essential tool that is used to ensure that drug benefits are administered as designed and that plan members receive the medication therapy that is safe, effective for their condition, and provides the greatest value.

Do all medications need prior authorization?

Not everything requires prior authorization. Theres a relatively easy way to check for both prescription drugs and medical services. There are two ways to check which drugs are covered by your plan. Check the list of covered drugs, also known as the drug formulary.