Get Ghp Family Formulary Information & Prior Authorization Procedure

This guide provides clear and comprehensive instructions for completing the GHP Family Formulary Information & Prior Authorization Procedure online. By following these steps, users can ensure accurate and timely submission of their requests for medication authorizations.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to access the GHP Family Formulary Information & Prior Authorization Procedure form and open it in your preferred editor.
2. Begin by entering the patient information. Fill in all required fields, including the patient's name, Member ID, date of birth, and contact details.
3. Provide prescriber information by entering the prescriber's name, NPI number (if available), and contact details including their office phone and fax number.
4. Specify the medication details, including whether it is a new prescription or a continuation of therapy, the strength and route of administration, and the expected length of therapy.
5. In the diagnosis and medical information section, enter any relevant diagnosis along with the patient's drug allergies and the quantity requested.
6. For the rationale for exception request or prior authorization, ensure to provide an explanation for the request. Include any alternate drugs attempted and document their adverse outcomes.
7. Review the completed form to confirm all sections are filled accurately. Ensure the prescriber’s signature is included.
8. Once you have completed the form, save your changes. You can then download, print, or share the form as necessary for submission. To submit, fax the form along with any required clinical information to the GHP Family Pharmacy Department at 570-271-5610.

Complete your GHP Family Formulary Information & Prior Authorization Procedure online today!