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The document is a request form for exceptions to coverage at Navitus Health Solutions, detailing the process for submitting requests for quantity limit increases or high dose medications. It includes sections for prescriber and patient information, as well as requirements for clinical rationale and supporting documentation. The form must be completed legibly and faxed to Navitus for review.

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2018	4.8 Satisfied (47 Votes)

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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.

What is an exception request in health insurance?

You can get an exemption so that you wont have to pay a penalty for not having qualifying health insurance. Some exemptions require an exemption application through Covered California. Other exemptions do not require an application: Instead, you can claim them when you file your state tax return.

What is a request for exception?

Exception Request means a process that allows a covered person, authorized representative, or prescribing physician (or other prescriber, as appropriate) to request and gain access to clinically appropriate drugs not otherwise covered by a health benefit plan.

What is an exception in medical billing?

Medical exception policies provide access to non-formulary medications when Medical Necessity is established. Medical exception policies provide access to Non-Formulary medication when Medical necessity is established.

What is an exception in an insurance policy?

Exceptions limit the application of an exclusion such that it does not apply to the described circumstances. For example, an exception to the commercial general liability (CGL) policys watercraft and aircraft exclusion leaves coverage in place for liability assumed in an insured contract.

What is a coverage determination request form?

A coverage determination (exception) is a decision about whether a drug prescribed for you will be covered by us and the amount youll need to pay, if any. If a drug is not covered or there are restrictions or limits on a drug, you may request a coverage determination.

navitus health solutions exception to coverage request form

Navitus prior authorization form PDF Navitus provider portal

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What is a medical exception request?

An exception request is a type of coverage determination. An enrollee, an enrollees prescriber, or an enrollees representative may request a tiering exception or a formulary exception.

What is the exception to coverage in Navitus?

The Exception to Coverage (ETC) process allows members to request coverage of medications that show formulary restrictions. The ETC form cannot be used to request copay lowering or coverage of a direct plan exclusion.

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