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  • Pharmacy Prior Authorization Request Form - Caresource

Get Pharmacy Prior Authorization Request Form - Caresource

P.O. Box 8738 Dayton, OH 45401-8738 Pharmacy Prior Authorization Request Form PHARMACY FAX # 866-930-0019 Note: Prior Authorization Requests without medical justification or previous medications listed.

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How to fill out the Pharmacy Prior Authorization Request Form - CareSource online

Filling out the Pharmacy Prior Authorization Request Form - CareSource online can be straightforward when you follow the right steps. This guide will assist you in completing the form accurately, ensuring all necessary information is included for a successful submission.

Follow the steps to fill out the form correctly.

  1. Click ‘Get Form’ button to obtain the Pharmacy Prior Authorization Request Form and open it for completion.
  2. Begin by providing the patient information. Fill in the patient's name, date, Humana - CareSource ID, date of birth, gender, medication allergies, pharmacy name, and pharmacy phone number.
  3. Next, move to the provider information section. Enter the prescriber's name, NPI number, DEA number, specialty, address, office fax, phone number, and contact name.
  4. In the medication requested section, include the drug name, strength, directions (Sig), duration of therapy (days and months), quantity, HbA1c with date (if applicable), diagnosis, and whether the patient is currently treated on this medication along with the start date if applicable.
  5. Provide details in the medical justification section. List any other relevant medications the patient has tried, including their strength, quantities, directions, dates of use, and reasons for discontinuation.
  6. Add any relevant medical rationale for the request or additional clinical information. It is essential to attach lab results and chart notes if available.
  7. Finally, ensure that the provider's signature and date are included. Review the form for completeness, as missing or illegible information will result in the request being returned.
  8. Once all sections are filled out correctly, you can save changes, download, print, or share the completed form as needed.

Complete your Pharmacy Prior Authorization Request Form online today to ensure a smooth approval process.

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A prior authorization (PA), sometimes referred to as a pre-authorization, is a requirement from your health insurance company that your doctor obtain approval from your plan before it will cover the costs of a specific medicine, medical device or procedure.

CareSource is a nonprofit that began as a managed health care plan serving Medicaid members in Ohio. Today, it provides public health care programs including Medicaid, Medicare, and Marketplace. ... It is the largest Medicaid plan in Ohio and is second in the United States.

Certain prescription medications need to be preapproved by Express Scripts before they will be covered. This preapproval process is known as prior authorization. If you do not receive approval for drugs requiring prior authorization, you may pay the full cost of the medication.

Health care providers usually initiate the prior authorization request from your insurance company for you. However, it is your responsibility to make sure that you have prior authorization before receiving certain health care procedures, services and prescriptions.

Services That Require a Referral and Prior Authorization There could also be times when both a referral from your PCP and prior authorization from Humana CareSource are needed before you can get a service. Your PCP will ask for a prior authorization from us. Then he or she will schedule these services for you.

Nonparticipating Providers All in-patient services require prior authorization. Please call 1-800-488-0134 to obtain prior authorization for emergency admissions. Outpatient emergency services do not require prior authorization.

Services That Require a Referral Sometimes you will need an OK from your doctor or from Humana CareSource® to see another doctor. Your primary care provider (PCP) will recommend or request these services for you before you can get them: ... Use our Find a Doctor/Provider tool to find participating specialists.

Prior authorization is not required for standard outpatient services. However, other services may require prior authorization, including those offered by non-participating providers.

CareSource members still have access to roughly 2,000 pharmacies across the state. This network includes major retail chains like CVS, Walmart, Giant Eagle, Rite Aid, Kroger and as well as 580 smaller independent pharmacies. Overall, CareSource manages Medicaid plans for over 1.2 million Ohio residents.

Among the nearly 2,000 pharmacies available to CareSource members are CVS, Walmart, Rite Aid, Meijer, Kroger, Giant Eagle, Drug Mart, , Marc's and Sam's Club pharmacies, as well as more than 580 independent neighborhood pharmacies across Ohio.

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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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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