Get Rexulti Prior Authorizationform - Caterpillar

Completing the Rexulti Prior Authorization Form - Caterpillar can seem daunting, but this guide provides clear, step-by-step instructions to help you through the process. By following these guidelines, you can ensure all necessary information is accurately submitted for your request.

Follow the steps to fill out the Rexulti Prior Authorization Form successfully.

1. Click ‘Get Form’ button to access the Rexulti Prior Authorization Form - Caterpillar, and open it for filling out.
2. In the prescriber information section, enter the last name, first name, DEA/NPI, specialty, phone, and fax of the prescriber making the request. Ensure all fields are correctly filled out.
3. Next, fill in the member information section with the member's last name, first name, member ID number, and date of birth. Accurate information is crucial.
4. In the medication information section, provide the drug name and strength. Additionally, specify the quantity and dosing accurately.
5. Complete the diagnosis and duration fields with the relevant details about the patient's condition. Be clear and concise.
6. Answer all required questions regarding the patient's diagnosis and previous medication trials. Ensure you provide any necessary documentation, such as lab results, as indicated.
7. Before submission, ensure that the prescriber or authorized signature is completed along with the date. Don’t forget to also include the authorized medical staff’s name and title.
8. Finally, review the entire form for completeness and accuracy. You can now save your changes, download, print, or share the completed form as required.

Take the first step towards submitting your Prior Authorization request online by completing the form today.