Get Brand Over Generic Prior Authorization Request Form - Pec

Navigating the Brand Over Generic Prior Authorization Request Form - PEC can be straightforward with the right guidance. This guide provides clear, step-by-step instructions to assist users in filling out the form accurately and effectively.

Follow the steps to complete the form efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. In the first section, complete the patient and physician information. Ensure to print or clearly write the patient's name, date of birth, address, and phone number, as well as the physician's name, address, and secure fax number.
3. Indicate the specific medication being prescribed by filling in the relevant field.
4. Next, address whether the patient has tried the generic product. If the answer is 'Yes,' provide an explanation of the patient’s experience with the generic. If 'No,' proceed to detail the patient-specific clinical justification for using the brand name drug instead.
5. In the final section, the prescriber must certify the information provided by signing and dating the form to confirm its accuracy.
6. Once all steps are completed, save the changes, and download the form. Finally, print or share the completed form as necessary.

Complete your forms online with confidence and ensure timely processing of your prior authorization requests.