The purpose of this step is to see if the request really does need an authorization. It may be a high copay or some other processing issue. A covered alternative can also be recommended if the patient's insurance covers a similar product (e.g. Novolog vs Humalog).

What To Do

Once the request has come over you will want to:

1. Make sure that is prescription was sent.
2. Check to see if an authorization is needed.

Prior Authorization

If an authorization is needed please attach the:

• Patient's demographic information (Address, DOB)
• Insurance Information (ID, GRP, BIN, PCN)
• Select Prior Authorization

No Authorization Required

If the request does not need an authorization you can mark:

• No Authorization Required

No Prescription

We tell most offices to send the prescription as soon as or shortly after the request is created. Some offices may take some time to send it, however if you feel enough time has passed and there is still no prescription, mark the request as:

• Prescription Needed

This will remind the office that a prescription needs to be sent to your pharmacy for the request.

Cancel

If the prescription needs to be canceled you can use this option.

• Select Cancel.
• It is recommended to add a comment so the prescriber will know the reason it was canceled (e.g. patient declined the drug).