Get Express Scripts Tricare Prior Authorization Form

Filling out the Express Scripts Tricare Prior Authorization Form online can streamline the process for obtaining approval for necessary medications. This guide will walk you through each step to ensure a smooth and efficient submission.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by entering the patient and prescriber information. Ensure that all fields, such as patient name, physician name, address, sponsor ID number, phone number, and date of birth, are completed clearly and accurately.
3. Proceed to fill out the clinical assessment section. For each question, select the appropriate option (Yes or No) based on the patient's condition. Questions involve trials of other medications and necessitate careful consideration.
4. After answering all clinical questions, ensure that the prescriber provides their signature and the date in the designated section to certify the accuracy of the information.
5. Review the form for completeness and accuracy. Make any necessary adjustments before finalizing the submission.
6. Once everything is confirmed, save changes, then download or print the form for submission. If preferred, you can share the completed form via email or fax as indicated in the instructions.

Get started on filling out your documents online today.