Get Msu Generic Prescribing Program Exception Request Form 2011-2025
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How to fill out the MSU Generic Prescribing Program Exception Request Form online
The MSU Generic Prescribing Program Exception Request Form is essential for requesting a brand-name drug instead of a generic alternative when a direct equivalent is available. This guide provides step-by-step instructions to help you successfully complete the form online.
Follow the steps to fill out the form online
- Click 'Get Form' button to access the form and open it in your usual document handling tool.
- Fill in the patient's name and date of birth accurately to ensure their records are correct.
- Provide the prescriber's information, including their name, phone number, and fax number. This verifies the source of the request.
- Indicate the brand-name drug, its strength, and dosage form, along with the specific diagnosis related to the prescription.
- List any generic alternatives that the patient has tried or considered, along with the dates these alternatives were tried.
- Explain the evidence showing that the generic alternatives are unsafe, ineffective, or have drug interactions that are relevant to the patient's current medications.
- Include any additional information that is pertinent to the patient's condition and this request. This could be medical history, allergies, or specific needs.
- Ensure the healthcare provider signs the form and dates it before submission.
- Once the form is completed, submit it along with any supporting documentation by faxing it to the CVS Caremark Appeals Department at the provided number.
- After submission, you can save changes, download, print, or share the form as necessary.
Complete your documents online to ensure proper processing of your exception request.
An exception form is a document that requests approval for a service or medication that typically falls outside standard protocols. In the case of medications, the MSU Generic Prescribing Program Exception Request Form serves this essential purpose. This form allows healthcare providers to advocate for specific treatments vital to patient care. By submitting this form, patients increase the likelihood of receiving necessary drugs even if they are not on the standard formulary.
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