Southern Scripts Prior Auth Form

Lowest Net-Cost ApproachSouthern Scripts' robust clinical management program and high-performance drug formularies deliver the lowest net cost to protect plans from unnecessary expenses. Concepts in Managed Care Pharmacy Series -- Formulary Management. Phone: (855) 225-3997. 1 Drugs that require prior authorization will not be approved for payment until the conditions for approval of the drug are met and the prior authorization is entered into the system. Southern scripts prior auth form 7. Administration of Quantity Management Rules: The prior authorization process can be used to administer quantity management rules, including rules based on duration of therapy, quantity over a period of time and maximum daily dose edits. Fax: (844) 508-4690.

1. Southern scripts prior auth form pdf
2. Southern scripts precertification form
3. Southern scripts prior auth form 7

Southern Scripts Prior Auth Form Pdf

Refill and renew prescriptions. Utilization of this logic allows plans to manage the benefit without requiring unnecessary member or prescriber disruption. A Transformative Pharmacy Benefit Management Solution. PA Logic distributes the specific clinical criteria used for clinical decisions upon request. Sign up for home delivery.

Southern Scripts Precertification Form

2 Robert Navarro, Michael Dillon and James Grzegorczyk, "Role of Drug Formularies in Managed Care Organizations, " in Managed Care Pharmacy Practice, ed. Customer Service: 800-552-6694Monday – Friday: 8 a. m. -8 turday: 11 a. Check the status of a prior authorization, review your drug list and enroll in the variable copay program from the app. Prior authorization would be used to limit coverage in this situation to those patients where safety and appropriate use has been documented. Implementation of a well-designed, evidence-based prior authorization program optimizes patient outcomes by ensuring that patients receive the most appropriate medications while reducing waste, error and unnecessary prescription drug use and cost. A 90-day supply of maintenance medications may be filled at Walgreens for a similar price as mail order. Trustmark & Southern Scripts. For specific questions about your coverage, call the phone number listed on your member card. Blue Cross Blue Shield of Alabama. Check out this flyer. The Academy of Managed Care Pharmacy's mission is to empower its members to serve society by using sound medication management principles and strategies to achieve positive patient outcomes. An NSAID step therapy rule requires that a patient try a traditional, generic NSAID or provide documentation of a gastrointestinal condition prior to receiving approval to fill a prescription for the newer, more expensive branded product.

Southern Scripts Prior Auth Form 7

This list may change, please contact Express Scripts for the most up to date information). Prior Authorization Support Numbers. The Academy of Managed Care Pharmacy (AMCP) recognizes the role of prior authorization in the provision of quality, cost-effective prescription drug benefits. They can identify and resolve the issue for you in real time. Prior authorization guidelines may stipulate that only certain medical specialists may prescribe a given medication. By employing the prior authorization process, plans can extend the duration of the therapy limit for patients who meet established parameters. FirstChoice™ Pharmacy Network. Southern scripts prior auth form pdf. Combat High-Cost Specialty Medications with Variable Copay™. A step therapy approach to care requires the use of a clinically recognized first-line drug before approval of a more complex and often more expensive medication where the safety, effectiveness and value has not been well established, before a second-line drug is authorized. If the cost of your prescription is less than the co-pay, no co-pay will be charged.

A 90-day supply is available through mail order. Specialty prescriptions are also available as a 30-day supply through mail order. The prior authorization process can be used to obtain this additional information. In most cases, a PBM can resolve the problem by reaching out to the pharmacy on your behalf. Southern scripts prior auth form pdf download. Ready to learn more? The process gives the prescriber the opportunity to justify the therapeutic basis for the prescribed medication. "Prior Authorization Programs: A Critical Review of the Literature. " Administration of Step Therapy: Another prior authorization approach is step therapy. Your GuideStone® medical plan utilizes Express Scripts® as our pharmacy benefit manager.