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RxResource Home > Pharmacy Resources > Pharmacy Benefit Management
2441 Warrenville Road, Suite 610 Lisle, IL 60532-3642
Susan Fleming, Vice President, Marketing
Phone: (630) 577-4880
http://www.catamaranrx.com/
Catamaran offers a true alternative to the status quo in pharmacy benefit management. You don't have to choose between the scale and purchasing power of the largest providers and the flexibility and agility of smaller ones. We offer the best of both.
At Catamaran, we put your individual needs - and those of your members - at the center of our services. We connect pharmacists, doctors and caregivers with prescription data to improve health outcomes, offering the clinical intelligence, technology and scale to lower payer costs while improving member health.
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Catamaran Pharmacy Prior Authorization Form
Catamaran Pharmacy Prior Authorization Form – A legal document, or an authorization form is a form that grants permission to carry out an action. It could include accessing personal information, receiving medical treatment, or performing financial transactions. Make a clear and concise authorization form that ensures everyone who is involved knows their rights and responsibilities.
The importance of Authorization Forms
These forms are vital to protect privacy and rights. They’re used to seek permission from the person giving authorization, and also to create a clear understanding between all participants. With an authorized form, you’ll be able avoid legal disputes.
Data Protection and Legal obligations
When you create an authorization form, it is essential to comply all relevant legal requirements. The legal requirements can differ from one country to another, which is why it is recommended to consult an attorney to ensure your forms conforms to all applicable standards. Furthermore, taking strict data protection measures will help protect the privacy of the individuals affected.
Best Practices in the Creation of Authorization Forms
- Keep it simple and straight-forward Create your authorization form as simple to comprehend as possible by using clear and simple language.
- State the purpose clearly Be careful not to use broad terms and state the specific reason for which the authorization was granted.
- Limit the scope: Define clearly the scope of the authorization as well as any limitations.
- Include a clause for revocation that gives the grantor to revoke their authorization at anytime.
- Obtain signature: Make sure that the form has an area for the grantor’s consent.
Guide for Designing Authorization Forms
- Begin with an Start with
A template can help you save time and ensure that your form contains all the necessary elements. Use a trusted source for an authorization form template, like online legal resources or website document templates. Choose a template that is specific to the authorization type you need and modify it to suit your needs.
- Include your company’s or organisation’s details
At the top, include the name, address and contact information of your organisation. This will help to identify all parties and establish the form as a formal document.
- Give a clear and specific reason to authorize the use of HTML0.
Declare the purpose and any obligations or actions involved. When filling out a medical authorization form, it is important to indicate the type of procedure, treatment, medication, etc. will be approved.
- Set a date for authorisation
Set a start and an end date, or an event that will trigger the expiration of the authorization. A timeframe clearly specified safeguards the rights of grantors and stops authorizations from becoming open ended.
- Outline scope and restrictions of authorization
Define the scope of the permission. Include any restrictions or limitations. If it is an authorization for financial transactions for instance, you should specify the maximum amount which can be transferred, or the types transactions that are permitted.
- Include a revocation clause
The grantor should be given instructions to cancel the authorization at any point. You may need to submit an email request or fill out the revocation paperwork separately.
- Gather personal information about the grantor
The full name, the address and the contact information of the person who is granting the authority should be requested. These details help confirm the identity of the grantor and give a means to reach them should there be any concerns.
- Provide a space for the grantor’s signature along with the date
Include a designated area for the grantor to fill in and date the form, confirming their consent to the authorization. The signature should be simple to recognize and include an affirmation that the grantor understands the content of the form and has consented.
- Add any witnesses that are required or Notary Sections
Include sections with their information and signatures if the state in which you live requires this. Talk to your legal professional about whether this is required in the authorization form you have.
A well-constructed and legally-compliant authorization form in English is essential for protecting the rights and privacy of all parties involved. By adhering to the guidelines and best practices laid out in this article and creating an effective authorization form that will serve its purpose and withstand legal examination. Confer with a lawyer to make sure that your document meets the legal requirements of your specific situation.
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Prior Authorization
How to request precertifications and prior authorizations for patients.
Depending on a patient's plan, you may be required to request a prior authorization or precertification for any number of prescriptions or services. A full list of CPT codes are available on the CignaforHCP portal .
For Medical Services
- Description of service
- Start date of service
- End date of service
- Service code if available (HCPCS/CPT)
To better serve our providers, business partners, and patients, the Cigna Healthcare SM Coverage Review Department is transitioning from PromptPA, fax, and phone coverage reviews (also called prior authorizations) to Electronic Prior Authorizations (ePAs). ePAs save time and help patients receive their medications faster. Moving forward, please visit CoverMyMeds or via SureScripts in your EHR to learn more and submit all new PA requests electronically.
If you are unable to use electronic prior authorization, you can call us at 1 (800) 882-4462 to submit a prior authorization request.
Related Documents
- Arkansas Prior Authorization Exemption Legislation FAQs
- Indiana Prior Authorization Form [PDF]
- MA Cardiac Imaging Prior Authorization Form [PDF]
- MA CT/CTA/MRI/MRA Prior Authorization Form [PDF]
- MA PET - PET CT Prior Authorization Form [PDF]
- Massachusetts Behavioral Health Prior Authorization Form [PDF]
- Massachusetts Transcranial Magnetic Stimulation Prior Authorization Form [PDF]
- Texas Prior Authorization Exemption Legislation FAQs [PDF]
- Texas Standard Prior Authorization Request Form for Health Care Services [PDF]
- Vermont Uniform Medical Prior Authorization [PDF]
- View more prior authorization forms at CignaforHCP
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Microsoft Word - img387.import.doc. 1650 Spring Gate Lane Las Vegas, NV 89134 Tel: 888-869-4600. Please Note: Medical Necessity Prior Authorization may be utilized to override both formulary coverage and benefit design restrictions. They are issued at the full discretion of the benefit manager.
Catamaran prescription prior authorization form ... Fax Pharmacy Fax Fax completed form at: 1 (888) 852-1832 An independent group of practicing physicians, pharmacists and other healthcare professionals on the P&T Committee often meets to look at new and existing medicines. They choose drugs for our
Summary. Catamaran offers a true alternative to the status quo in pharmacy benefit management. You don't have to choose between the scale and purchasing power of the largest providers and the flexibility and agility of smaller ones. We offer the best of both. At Catamaran, we put your individual needs - and those of your members - at the center ...
The prescriber will have to fill out the form below in full, providing all medical justifications for requesting a particular drug. Once completed, it can be faxed to Fidelis Care. Typically, the answer can be expected within three (3) business days. Step 1 - Download Adobe PDF to get started.
Page 1 of 2. Catamaran Prior Authorization Department Phone: 800-626-0072 Fax: 866-511-2202. Attention Healthcare Provider: If you would like to discuss this request with a medical professional, please contact the Prior Authorization Department at 800-626-0072. I understand that Catamaran's use or disclosure of individually identifiable ...
Prior authorization 4. My medication requires prior authorization. Will I need to go through this process again? Current prior authorizations will remain active until they expire. You can find the expiration date in your original authorization letter, by calling customer service at the member number on your ID card or by visiting your member ...
Pharmacy Prior Authority General Requirements and Procedures. Clan Member/Associate Transportation Providers ... and dated prior authorization fax form and aforementioned necessary supporting clinical documentation of medical ... Provider References. ... The Catamaran Prior Prescription Authorization Application allowing beneficiaries ...
Prior Authorization (PA) is a clinical program designed to help meet these goals. What is Prior Authorization (PA)? Prior Authorization means that approval must be given for certain medications to be covered by your plan. Catamaran works with your doctor or provider to make sure coverage is appropriate. How does a Prior Authorization Program work?
3. Have your doctor fax the completed form to Catamaran Home Delivery, at 1-800-893-2299 4. Allow 2 weeks for delivery FORM INSTRUCTIONS Telephone: 1-800-763-0044 (Option "7" for a Pharmacist) Fax: 1-800-893-2299 By providing this form, you have authorized release of all information to Catamaran Home Delivery, as needed
Catamaran Pharmacy Prior Authorization Form - A legal document, or an authorization form is a form that grants permission to carry out an action. It could include accessing personal information, receiving medical treatment, or performing financial transactions.
service. If a pharmacy has an issue, your pharmacist can call the Catamaran PBM Help Desk at 1-866-391-1164. Catamaran representatives will be available to provide support during the transition process. If you'd like to order a new member ID card, call the BCBSRI Customer Service number printed on the back of your old card.
OptumRX. OptumRX. OptumRx is the Pharmacy Benefits Manager for the Georgia Medicaid Fee For Service Outpatient Pharmacy Program. It processes all Fee For Service outpatient pharmacy claims on-line through Point of Sale transmission utilizing the NCPDP 5.1 communications standard. It also pays enrolled pharmacy providers weekly.
Fill Catamaran Prior Authorization Form, Edit online. Sign, fax and printable from PC, iPad, tablet or mobile with pdfFiller Instantly. Try Now! Home; ... Specialty Pharmacy 1-877-634-9202 Specialty Drug Prior Authorization Request Form COMPLETE AND FAX TO CATAMARAN 1-888-852-1832 PHYSICIAN INFORMATION Contact Person Physician Name Date Faxed ...
Authorization form - English PDF Formulario Estándar de Autorización para la Divulgación de Información de Salud Protegida (PHI) (Español) Usamos este formulario para obtener su consentimiento por escrito para divulgar su información de salud protegida (protected health information, PHI) a alguien que usted haya designado.
OptumRx
Specialty Pharmacy: 1-855-427-4682 Visit Specialty Pharmacy at - www.specialty.optumrx.com For technical website issues or password resets:1-800-788-4863 TTY (for the hearing impaired): 711 Physician Contacts: Prior authorization or exception request: 1-800-711-4555, option 2
OptumRx Provider Manual: 2016 2nd edition 5 The information contained in this document is proprietary and confidential to OptumRx. Table of contents Click on any section or page below to go directly to that portion of the document.
issues with service. If a pharmacy has an issue, their pharmacist can call the Catamaran PBM Help Desk at 1-866-391-1164. Catamaran representatives will be available to provide support during the transition process. If they would like to order a new member ID card, they can call the BCBSRI Customer Service number printed on the back of their ...
Prior Authorization Pharmacy Technician (Former Employee) - Fort Lauderdale, FL - April 9, 2019. I worked at Catamaran RX for 7 years. When I started it was called Catalyst Rx and then changed to Catamaran RX and now is called Optum RX. When changed to Catamaran RX, corporate decided to closed the office located in Ft Lauderdale, FL.
Prior Authorization Process and Criteria. The Georgia Department of Community Health establishes the guidelines for drugs requiring a Prior Authorization (PA) in the Georgia Medicaid Fee-for-Service/PeachCare for Kids® Outpatient Pharmacy Program. To view the summary of guidelines for coverage, please select the drug or drug category from the ...
The Prescription Drug Prior Authorization form may be completed by the prescriber and faxed to Magellan Rx Management at 800-424-3260. For drug specific forms please see the Forms tab under Resources. Please alert the member that the above steps will take additional time to complete. If this is an urgent prescription, have the member call ...
PA Forms for Physicians. When a PA is needed for a prescription, the member will be asked to have the physician or authorized agent of the physician contact our Prior Authorization Department to answer criteria questions to determine coverage. If a form for the specific medication cannot be found, please use the Global Prior Authorization Form.
For Medical Services. To better serve our providers, business partners, and patients, the Cigna Healthcare SM Coverage Review Department is transitioning from PromptPA, fax, and phone coverage reviews (also called prior authorizations) to Electronic Prior Authorizations (ePAs). ePAs save time and help patients receive their medications faster.
FAX Completed Form To 1 (800) 574-2515 Provider Help Desk 1 (877) 776-1567 ... Prescriber must complete all information above. It must be legible, correct, and complete or form will be returned. Pharmacy NPI Pharmacy fax NDC Preferred agents are available without prior authorization (PA) when dosed within the established quantity limits ...