Get Natpara - Assurant Health

This guide provides clear and detailed instructions on how to complete the Natpara - Assurant Health prior authorization request form. Follow the steps carefully to ensure that all necessary information is accurately submitted.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Enter the patient's name and date in the designated fields at the top of the form.
3. Provide the patient's ID and date of birth in the corresponding sections.
4. Fill in the physician’s name, specialty, NPI number, and contact information, including office telephone and fax number.
5. Indicate the prescribed drug by checking the appropriate box for Natpara or specifying another medication.
6. Provide the patient's diagnosis by checking the relevant option or selecting 'Other' and describing the diagnosis.
7. Enter the ICD code associated with the diagnosis in the specified field.
8. Answer the questions regarding post-surgical hypoparathyroidism, calcium-sensing receptor mutations, and risk factors for osteosarcoma by selecting 'Yes' or 'No' for each one.
9. Complete sections 7 through 13 by indicating whether Natpara is prescribed for controlling hypocalcemia, its use with calcium supplements, and providing serum calcium levels, 25-hydroxyvitamin D levels, and serum magnesium levels as required.
10. If the patient is currently on Natpara therapy, answer additional questions related to current Total serum calcium, vitamin D levels, and whether adjustments are being made to medications.
11. Attach the necessary laboratory reports as indicated in the sections, ensuring you have included all required documentation.
12. Review the completed form to confirm that all information is accurate and true before signing and dating the document.
13. Save the changes, then download, print, or share the form as needed to submit it to Assurant Health.

Complete your Natpara - Assurant Health prior authorization request form online today.