Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form NOFR002 for the current year.

Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas

What Is Form NOFR002?

This is a legal form that was released by the Texas Department of Insurance - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the NOFR002 Texas Standard Prior Authorization Request Form?
A: The NOFR002 form is the Texas Standard Prior Authorization Request Form for Prescription Drug Benefits.

Q: What is the purpose of the NOFR002 Texas Standard Prior Authorization Request Form?
A: The purpose of the form is to request prior authorization for prescription drug benefits in Texas.

Q: How can I obtain the NOFR002 Texas Standard Prior Authorization Request Form?
A: You can obtain the form from your healthcare provider or insurance company.

Q: What information is required on the form?
A: The form requires information such as the patient's personal details, the prescribing physician's information, the requested medication, and supporting documentation.

Q: Who needs to complete the form?
A: The form should be completed by the prescribing physician or healthcare provider.

Q: What happens after submitting the form?
A: After submitting the form, the insurance company or pharmacy benefits manager will review the request and determine if prior authorization is approved.

Q: How long does it take to get a decision after submitting the form?
A: The timeframe for a decision varies depending on the specific insurance company or pharmacy benefits manager.

Q: What should I do if my request is denied?
A: If your request is denied, you may have options for appealing the decision. Contact your insurance company for more information.

Q: Is there a fee for submitting the NOFR002 Texas Standard Prior Authorization Request Form?
A: There is typically no fee for submitting the form, but check with your insurance company or pharmacy benefits manager to confirm.

ADVERTISEMENT

Form Details:

  • Released on June 1, 2015;
  • The latest edition provided by the Texas Department of Insurance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form NOFR002 by clicking the link below or browse more documents and templates provided by the Texas Department of Insurance.

Download Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas

4.6 of 5 (48 votes)
  • Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas

    1

  • Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas, Page 2

    2

  • Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas, Page 3

    3

  • Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas, Page 1
  • Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas, Page 2
  • Form NOFR002 Texas Standard Prior Authorization Request Form for Prescription Drug Benefits - Texas, Page 3
Prev 1 2 3 Next
ADVERTISEMENT

Related Documents