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Get Tufts Prior Authorization Form
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How to fill out the Tufts Prior Authorization Form online
Filling out the Tufts Prior Authorization Form online is an essential step for submitting pharmacy requests that require review by Tufts Health Plan. This guide provides clear instructions to help you complete the form accurately and efficiently.
Follow the steps to complete your form with ease.
- Press the ‘Get Form’ button to access the Tufts Prior Authorization Form and open it in the editor.
- Begin by filling in the patient information section. Enter the patient's name, date of birth, and member ID. Ensure all details are accurate to avoid processing delays.
- Next, input the prescriber information. Include the prescriber's name, specialty, phone number, and Tufts Health Plan provider ID. It is critical that this information is correct, as it identifies the person responsible for the request.
- In the requested drug section, specify the drug name and strength. Select either 'Dispense As Written' or 'Generic Substitution Authorized' based on your preference.
- For Tufts Medicare Preferred HMO, PDP, and Senior Care Options members, indicate if the member's condition requires expedited review by checking 'Yes' or 'No.' If 'Yes,' certify that the standard review time may jeopardize the member's health.
- Complete the clinical justification for the request. Provide detailed information regarding any adverse reactions or treatment failures, along with the rationale for needing the requested drug.
- If applicable, answer the question regarding whether the request is for a tier exception. Check 'Yes' or 'No' and provide any necessary documentation to support your request.
- After filling in all sections, review the form to ensure accuracy and completeness. A signature from the prescriber is required to finalize the submission.
- Once satisfied, save your changes to the form. You may download, print, or share the completed form as needed.
Complete your Tufts Prior Authorization Form online today to ensure timely processing.
While submitting a prior authorization request yourself is generally not standard practice, you can support your healthcare provider in gathering necessary information. Discussing your needs and ensuring they have the Tufts Prior Authorization Form can expedite the process. Communication is key, so don’t hesitate to remain proactive.
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