Get Hmsa Prior Authorization Request Cvs Caremark Administers The Prescription Benefit Plan

This guide provides a clear and supportive approach to completing the HMSA Prior Authorization Request. By following the steps outlined, users can ensure that all necessary information is accurately submitted to obtain approval for the prescribed medication.

Follow the steps to successfully complete and submit the authorization request.

1. Press the ‘Get Form’ button to access the authorization request form and open it in your preferred editing tool.
2. Fill in the patient's name, date, patient ID, and date of birth in the respective fields. Ensure that this information is accurate to avoid processing delays.
3. Complete the physician's information by providing their full name, specialty, NPI number, office telephone, and fax number.
4. Record additional demographic information such as the patient's weight and height in the designated areas.
5. Address the criteria questions carefully. Start by indicating where the drug will be administered by checking the appropriate box.
6. For question two, indicate whether the member has a diagnosis of active systemic lupus erythematosus (SLE) by selecting 'Yes' or 'No.'
7. Provide the ICD-10 code for the diagnosis in the specified field.
8. Choose whether the request is for a new start or continuation of therapy with and fill out subsequent questions based on your selection.
9. Answer the remaining criteria questions regarding the previous authorization, benefits, and treatment history truthfully and completely.
10. After completing all sections of the form, review the information for accuracy and completeness.
11. Once verified, save your changes. You can then download, print, or share the form as needed, and send it via fax to CVS Caremark at the provided number.

Complete your authorization request online to ensure timely processing and access to necessary medications.