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  • Prior Authorization Criteria Form - Caremark

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Prior Authorization Criteria Form CVS-CAREMARK FAX FORM Step Therapy This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign and date.

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Did you know submitting prior authorizations (PAs) by fax or phone can take anywhere from 16 hours to 2 days to receive a determination? CVS Caremark has made submitting PAs easier and more convenient. Some automated decisions may be communicated in less than 6 seconds!

Our PA criteria are: based on the latest FDA-approved product labeling, uses listed in authorized compendia supported by an adequate level of clinical evidence, national guidelines and peer-reviewed literature published in scientific journals where the drug is recommended as safe and effective.

Under medical and prescription drug plans, some treatments and medications may need approval from your health insurance carrier before you receive care. Prior authorization is usually required if you need a complex treatment or prescription. Coverage will not happen without it.

What should I do? All appeals are handled by CVS Caremark, our pharmacy benefits manager. Call Caremark at (877) 522-8679 to begin the process, to ask questions about how to appeal and to check the status of your appeal.

The CVS/caremark Prior Authorization number is 1-800-294-5979.

What types of prescriptions require prior authorizations? Brand-name drugs that have a generic available. Drugs that are intended for certain age groups or conditions only. Drugs used only for cosmetic reasons. Drugs that are neither preventative nor used to treat non-life-threatening conditions.

Yes. You and your doctor will be notified by letter of the approval or denial. You can check the status of your PA by signing in to your Caremark.com account and visiting Plan Benefits > Prior Authorization.

Prior authorization requires the prescriber to receive pre-approval for prescribing a particular drug in order for that medication to qualify for coverage under the terms of the pharmacy benefit plan.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232